Clinical observation of recombinant human thrombopoietin in the treatment of thrombocytopenia in patients with non small cell lung cancer induced by chemotherapy

HUANG Letian; HAN Chengbo; MA Jietao; ZHANG Shuling; ZOU Hua-wei

doi:10.3969/j.issn.1671-6450.2016.09.004

Abstract：Objective To explore the therapeutic effect and safety of prophylactic use of recombinant human thrombo -poietin ( rhTPO) in the treatment of thrombocytopenia in patients with non small cell lung cancer ( NSCLC) induced by chem-otherapy.Methods Pathologically confirmed NSCLC patients , with grade II or III thrombocytopenia in two weeks , after the first cycle of chemotherapy with gemcitabine and cisplatin or carboplatin , were randomly divided into four groups ( A, B, C, D), and underwent three identical cycles of chemotherapy , from September 2012 to February 2015, in China Medical Univer-sity.Group A received subcutaneous injection of rhTPO (1 μg· kg-1 · d-1 ) on the 1st, 3rd, 5th day before chemotherapy , and the 2nd, 4th, 6th, 9th day of cycle.Group B received subcutaneous injection of rhTPO (1μg· kg-1· d-1) on the 1st, 3rd day before chemotherapy , and the 2nd, 4th, 6th, 9th day of cycle.Group C received subcutaneous injection of rhTPO (1μg· kg-1· d-1) on the 1st day before chemotherapy, and the 2nd, 4th, 6th, 9th day of cycle.No rhTPO was received in group D.The efficacy and adverse effects were observed .Results A total of 36 patients were enrolled , with 9 patients in each group.Compared with group D , the patients in group A , B, C were showed a significantly higher nadir platelet count , shorter duration of thrombocytopenia and recovery of platelet count , less days delayed ( P <0.05).Compared with group B and C, the patients in group A showed a significantly higher nadir platelet count , shorter duration of thrombocytopenia ( <50 ×10 9/L), and recovery of platelet count (≥75 ×109/L) ( P <0.05).The difference between four groups was statistically signifi-cant( F =14.993, F =9.563, F =22.285, F =9.011, F =12.310,all the P value was 0.000).Compared with group C and group D , group A was statistically significant in less platelet transfusion .No serious adverse effects was observed in all groups.Conclusion For NSCLC patients with severe thrombocytopenia caused by GP or GC chemotherapy , prophylactic use of rhTPO can significantly reduce the degree and duration of thrombocytopenia , reduce the treatment times of platelet transfu-sion, and ensure the accuracy of the time and dosage of chemotherapy .The intermittent preventive strategies , which began with the 5 days before chemotherapy , were the best choice .The adverse effects of rhTPO were mild and well tolerated .