血小板减少症和肝损伤是肿瘤患者常见且严重的临床问题。肿瘤合并肝损伤患者血小板减少症(thrombocytopenia in cancer patients with liver injury,TCLI)的病因更加复杂,但常见于肝损伤和肿瘤治疗。肿瘤治疗所致血小板减少症的管理已...血小板减少症和肝损伤是肿瘤患者常见且严重的临床问题。肿瘤合并肝损伤患者血小板减少症(thrombocytopenia in cancer patients with liver injury,TCLI)的病因更加复杂,但常见于肝损伤和肿瘤治疗。肿瘤治疗所致血小板减少症的管理已逐渐形成规范,肝损伤相关血小板减少症随着相关药物的获批上市,管理日益明晰。但肿瘤合并肝损伤患者血小板减少症的管理仍是空白,血小板减少症和肝损伤的叠加进一步增加了肿瘤治疗的难度。为此,中国抗癌协会肿瘤支持治疗专业委员会组织专家对文献进行分析和讨论,形成肿瘤合并肝损伤患者血小板减少症管理中国专家共识(2022版),以指导临床实践。展开更多
Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associ...Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.展开更多
文摘血小板减少症和肝损伤是肿瘤患者常见且严重的临床问题。肿瘤合并肝损伤患者血小板减少症(thrombocytopenia in cancer patients with liver injury,TCLI)的病因更加复杂,但常见于肝损伤和肿瘤治疗。肿瘤治疗所致血小板减少症的管理已逐渐形成规范,肝损伤相关血小板减少症随着相关药物的获批上市,管理日益明晰。但肿瘤合并肝损伤患者血小板减少症的管理仍是空白,血小板减少症和肝损伤的叠加进一步增加了肿瘤治疗的难度。为此,中国抗癌协会肿瘤支持治疗专业委员会组织专家对文献进行分析和讨论,形成肿瘤合并肝损伤患者血小板减少症管理中国专家共识(2022版),以指导临床实践。
基金supported by grants from the Demonstrative Research Platform of Clinical Evaluation Technology for New Anticancer Drugs(Grant Nos.18ZX09201-015 and 2017ZX09304015)the Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences(Grant No.CIFMS,2016-I2M-1-001)。
文摘Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.
