Recombinant human thrombopoietin in treatment of acute myeloid leukemia thrombocytopenia after chemotherapy: a real-world study

doi:10.16138/j.1673-6087.2022.04.003

Abstract

Abstract:

Objective To explore the clinical efficacy and safety of recombinant human thrombopoietin(rhTPO) on chemotherapy induced thrombocytopenia(CIT) in the patients with acute myeloid leukemia(AML). Methods A total of 529 AML patients who received initial induction chemotherapy in our hospital were enrolled and were classified into a treatment group (393 cases, receiving rhTPO treatment) and a control group (136 cases, not receiving rhTPO treatment) according to their therapeutic protocols. After chemotherapy, comparisons between two groups were made on the days of the blood platelet count(BPC) less than 10×10⁹/L, 20×10⁹/L, 30×10⁹/L, 50×10⁹/L, the count of infusion thrombocytes, the days of platelet transfusion and the incidence of adverse reactions. Results The days of BPC less than 10×10⁹/L, 20×10⁹/L, 30×10⁹/L, the total account of platelet infusion and the days of platelet transfusion had no difference between two groups (all P>0.05). The days of BPC restored to more than 50×10⁹/L in the treatment group were less than those in the control group significantly（P<0.05）. In the patients with BPC less than 50×10⁹/L on the first visit, both the days of BPC less than 20×10⁹/L and the days of BPC restored to more than 50×10⁹/L in the treatment group after chemotherapy were less than those in the control group (P<0.05). The early mortality and the incidence of bleeding events in treatment group were significantly less than those in the control group (P<0.05). Conclusions rhTPO can be well tolerated, and it is able to reduce the duration of CIT, the early mortality, and the incidence of bleeding events in the patients with AML after chemotherapy.

Key words: Recombinant human thrombopoietin, Acute myeloid leukemia, Thrombocytopenia, Early death

CLC Number:

R733.71

JIANG Tianyi, LIU Fujia, CHENG Wenyan, ZHAO Huijin, SHEN Yang. Recombinant human thrombopoietin in treatment of acute myeloid leukemia thrombocytopenia after chemotherapy: a real-world study[J]. Journal of Internal Medicine Concepts & Practice, 2022, 17(04): 283-288.

Figures/Tables 3

References 15

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临床特点	对照组（n=136）	rhTPO治疗组（n=393）	χ²/Z	P
年龄（岁）	47.0（32.5, 60.0）	45.0（32.0, 57.0）	-1.588	0.112
男性[n（%）]	70（51.47）	210（53.44）	0.157	0.692
FAB分型[n（%）]			3.247	0.668
M1	2（1.5）	6（1.5）
M2	18（13.2）	61（15.5）
M4	43（31.6）	141（35.9）
M5	36（26.5）	94（23.9）
M6	4（2.9）	5（1.3）
其他	33（24.3）	86（21.9）
ELN危险度分层[n（%）]			3.798	0.284
低危	17（12.5）	57（14.5）
中危	75（55.2）	239（60.8）
高危	15（11.0）	40（10.2）
其他	29（21.3）	57（14.5）
化疗方案[n（%）]			0.725	0.394
标准“3+7”诱导化疗	124（91.2）	348（88.5）
减量化疗或其他强度较低的治疗	12（8.8）	45（11.5）
WBC（×10⁹/L）	13.72（5.00, 45.02）	12.43（3.13, 67.00）	-0.962	0.336
Hb（g/L）	92.00（75.50, 111.50）	84.00（67.00, 103.00）	-2.096	0.036
BPC（×10⁹/L）	51.00（25.50, 103.50）	46.00（23.00, 97.00）	-1.390	0.165

指标	对照组（n=117）	rhTPO治疗组（n=367）	Z	P
BPC<10×10⁹/L的持续天数（d）
总计	4（0, 6）	3（1, 6）	-1.626	0.104
初诊BPC<50×10⁹/L	5（3, 7）	3（1, 6）	-2.678	0.007
初诊BPC≥50×10⁹/L	3（0, 5）	3（2, 5）	-0.447	0.655
BPC<20×10⁹/L的持续天数（d）
总计	9（6, 12）	8（5, 12）	-1.674	0.094
初诊BPC<50×10⁹/L	10（7, 13）	9（5, 12）	-1.078	0.281
初诊BPC≥50×10⁹/L	8.50（5.25, 11.00）	7（4, 11）	-1.523	0.128
BPC<30×10⁹/L的持续天数（d）
总计	12（10, 15)	12（9, 15）	-1.020	0.308
初诊BPC<50×10⁹/L	13（11, 16)	12（10, 16）	-1.246	0.213
初诊BPC≥50×10⁹/L	12.00（8.25, 14.00）	11（8, 14）	-0.492	0.623
BPC<50×10⁹/L的持续天数（d）
总计	16（14, 19)	15（13, 18）	-2.253	0.024
初诊BPC<50×10⁹/L	17（15, 19)	16（14, 18）	-2.443	0.015
初诊BPC≥50×10⁹/L	15.00（12.25, 19.00）	14（12, 17）	-0.969	0.333
血小板输注数量(U)
总计	4（3, 6）	4（3, 5）	-0.124	0.901
初诊BPC<50×10⁹/L	5（3, 6）	4（3, 6）	-0.184	0.854
初诊BPC≥50×10⁹/L	4（3, 5）	4（3, 5）	-0.204	0.839
依赖血小板输注的天数（d）
总计	10（7, 14）	10（6, 13）	-0.360	0.719
初诊BPC<50×10⁹/L	11（8, 14）	11（8, 14）	-0.619	0.536
初诊BPC≥50×10⁹/L	10（6, 13）	9（5, 13）	-0.156	0.876