阿伐曲泊帕治疗肿瘤化疗所致血小板减少症的疗效及安全性的回顾性研究  

Efficacy and safety of avatrombopag in the treatment of chemotherapy-induced thrombocytopenia:a retrospective study

作　　者：李红梅[1] 余文熙[2] 彭志刚[3] 臧远胜 李文瑜[5] 王磊[6] 朱学强[7] 李建成[8] 唐友红[9] 洪少东 沈赞[2] LI Hongmei;YU Wenxi;PENG Zhigang;ZANG Yuansheng;LI Wenyu;WANG Lei;ZHU Xueqiang;LI Jiancheng;TANG Youhong;HONG Shaodong;SHEN Zan(Department of Chemotherapy for Tumor,The Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong Province,China;Department of Medical Oncology,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Department of Medical Oncology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;Department of Oncology,Changzheng Hospital Affiliated to Naval Medical University,Shanghai 200001,China;Department of Lymphoma,Guangdong Provincial People’s Hospital,Ghuangzhou 510055,Guangdong Province,China;Department of Radiotherapy,Zhejiang Cancer Hospital,Hangzhou 310022,Zhejiang Province,China;Oncology Center,Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China;Department of Radiotherapy for Thoracic Tumor,Fujian Cancer Hospital,Fuzhou 350005,Fujian Province,China;Department of Oncology,Xiangya Hospital Central South China,Changsha 410008,Hunan Province,China;Department of Medical Oncology,Sun Yatsen University,Guangzhou 510060,Guangdong Province,China)

机构地区：[1]青岛大学附属医院肿瘤化疗科,山东青岛266000 [2]上海市第六人民医院肿瘤内科,上海200233 [3]广西医科大学第一附属医院肿瘤内科,广西壮族自治区南宁530021 [4]海军军医大学附属长征医院肿瘤科,上海200001 [5]广东省人民医院淋巴瘤科,广东广州510055 [6]浙江省肿瘤医院放射治疗科,浙江杭州310022 [7]四川省人民医院肿瘤中心,四川成都610072 [8]福建省肿瘤医院胸部肿瘤放疗科,福建福州350005 [9]中南大学湘雅医院肿瘤科,湖南长沙410008 [10]中山大学附属肿瘤医院肿瘤内科,广东广州510060

出　　处：《肿瘤》2021年第12期832-839,共8页Tumor

摘　　要：目的:观察阿伐曲泊帕治疗肿瘤化疗所致血小板减少症(chemotherapy-induced thrombocytopenia,CIT)的有效性和安全性。方法:回顾性收集2020年8月—2020年11月在包括上海市第六人民医院在内的全国20家医院内接受阿伐曲泊帕治疗的CIT患者,纳入化疗后发生≥1级血小板减少症(血小板计数≤100×10^(9)/L)的患者。研究人员结合患者实际情况,指导患者口服阿伐曲泊帕片剂(20~60)mg/d(20 mg/片)。所有患者至少连续口服阿伐曲泊帕5 d,或达到停药指征(血小板计数≥100×10^(9)/L或较用药前升高≥50×10^(9)/L)。记录患者血小板计数的变化。结果:本研究共纳入101例符合病例选择标准的CIT患者,化疗周期X(接受阿伐曲泊帕治疗的当前化疗周期)内的阿伐曲泊帕升血小板有效率为87.1%(88/101)。不同性别、肿瘤类型、体质指数、TNM分期、肿瘤转移部位、基线血小板计数以及化疗周期数的患者的升血小板有效率差异均无统计学意义(P>0.05)。化疗周期X内,仅1例(1.0%)患者发生出血事件、25例(24.8%)患者接受血小板输注;未发现阿伐曲泊帕相关不良反应的记录。结论:阿伐曲泊帕治疗CIT的疗效较好且不良事件发生率低,可以建议用于临床治疗CIT。Objective:To observe the efficacy and safety of avatrombopag in treatment of chemotherapy-induced thrombocytopenia(CIT).Methods:This study retrospectively investigated patients with CIT treated by avatrombopag in Shanghai Sixth People’s Hospital and other 19 hospitals in China,from August 2020 to November 2020.Patients with≥grade 1 thrombocytopenia(platelet count≤100×10^(9)/L)induced by chemotherapy were included,and the patients were guided to take 20 mg(1 tablet)-60 mg(3 tablets)avatrombopag daily based on their actual conditions.All patients were treated for at least 5 consecutive days unless reaching the withdrawal indication(platelet count≥100×10^(9)/L or platelet count elevation≥50×10^(9)/L vs the baseline).The change in platelet count was recorded.Results:A total of 101 eligible patients were recruited,and the efficacy rate of platelet count rising in chemotherapy-cycle X(current chemotherapy cycle receiving avatrombopag)was 87.1%(88/101).There were no significant differences in the response rates of platelet count rising in patients according to different genders,tumor types,body mass index(BMI),TNM stages,tumor metastasis sites,baseline platelet counts,and the number of chemotherapy cycles(P>0.05).cycles(P>0.05).Onlyonepatient(1.0%)developed bleeding events,and 25 patients(24.7%)received platelet transfusion during chemotherapy-cycle X.There were no records of adverse events related to avatrombopag.Conclusion:The efficacy of avatrombopag in the treatment of CIT is favorable with few adverse events,thus avatrombopag could be recommended for CIT in clinical practice.

关 键 词：阿伐曲泊帕 化疗所致血小板减少症 疗效 安全性 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R730.5[医药卫生—内科学]