艾曲泊帕用于实体瘤化疗导致血小板减少的文献综述及病例报告2例

A literature review and two case reports of using eltrombopag for thrombocytopenia induced by chemotherapy in patients with solid tumors

目的:总结分析艾曲泊帕用于实体瘤化疗导致血小板减少的临床疗效和安全性,并结合我院收治病例,复习相关文献。方法:检索Pubmed,Web of Science,CNKI,Wanfang datebase等中英文数据库,筛选艾曲泊帕预防或治疗实体瘤化疗导致血小板减少的非综述性文章,并对相关病例总结分析,结合文献对我院收治病例进行讨论。结果:检索到艾曲泊帕用于实体瘤化疗导致血小板减少的随机对照试验(RCT)3篇,回顾观察研究2篇,共获取病例298例。结果显示艾曲泊帕可以提高化疗期间血小板最低值,降低3/4级血小板减少不良事件的发生率,从而减少化疗周期延迟和剂量强度降低。艾曲泊帕的耐受性普遍良好,偶有恶心和脱发的不良反应。对于我院2例化疗导致的难治性血小板减少症患者艾曲泊帕具有一定疗效。结论:艾曲泊帕可安全有效提高血小板数量,有望成为限制化疗进行的血小板减少症患者的治疗方法,但仍需进一步临床试验数据支持。

Objective: To summarize and analyze the clinical efficacy and safety of eltrombopag in the treatment of solid tumor chemotherapy-induced thrombocytopenia, and review relevant literature based on the cases admitted to our hospital.Methods: Non-review articles on the prevention or treatment of solid tumor chemotherapyinduced thrombocytopenia with eltrombopag were screened, and relevant cases were summarized and analyzed, and the cases admitted to our hospital were discussed in combination with literature.Results: Three randomized controlled trials(RCTs) and two retrospective observational studies of eltrombopag for solid tumor chemotherapyinduced thrombocytopenia were retrieved, and a total of 298 cases were collected. The results showed that eltrombopag could improve the minimum platelet value during chemotherapy, reduce the incidence of grade Ⅲ/Ⅳ thrombocytopenia adverse events, thereby reducing the chemotherapy cycle delay and dose intensity. Eltrombopag was generally well tolerated, with occasional adverse reactions such as nausea and hair loss. Eltrombopag had certain therapeutic effect on two patients with chemotherapy-induced intractable thrombocytopenia in our hospital.Conclusion:Eltrombopag is safe and effective to increase platelet count and is expected to be an alternative option in the treatment of patients with thrombocytopenia that limits chemotherapy, but further clinical trial data are needed to confirm these results.