rhTPO联合异基因造血干细胞移植对AML患者血小板恢复的影响  

Effects of rhTPO combined with allogeneic hematopoietic stem cell transplantation on platelet recovery in patients with acute myeloid leukemia

作　　者：朱鸿燕[1] 谭鹰[1] 王清松[1] 周莉[1] 阳梅[1] ZHU Hongyan;TAN Ying;WANG Qingsong;ZHOU Li;YANG Mei(Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院血液内科,四川成都610041

出　　处：《西部医学》2023年第10期1465-1468,共4页Medical Journal of West China

基　　金：四川省卫生厅科研项目(150115)。

摘　　要：目的探讨重组人血小板生成素(rhTPO)联合异基因造血干细胞移植(allo-HSCT)对急性髓系白血病(AML)患者血小板恢复的影响。方法选取2020年1月—2021年12月本院收治的74例AML患者为研究对象,随机分为对照组和观察组,每组37例。对照组予以allo-HSCT治疗,观察组予以rhTPO联合allo-HSCT治疗。比较治疗后两组血小板重建时间和血小板恢复时间、凝血功能指标[凝血酶原时间(PT)、纤维蛋白(FIB)、部分凝血活酶时间(APTT)]、炎症因子指标[降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素-6(IL-6)]、血管指标[血管内皮生长因子(VEGF)和血管内皮生长因子C(VEGF-C)]以及治疗期间的不良反应发生情况。结果治疗后,观察组血小板重建时间和血小板恢复时间均短于对照组(P<0.05);观察组APTT和PT水平低于对照组,FIB水平高于对照组(均P<0.05);观察组PCT、CRP及IL-6水平低于对照组(P<0.05);观察组VEGF和VEGF-C水平高于对照组(P<0.05)。治疗期间,对照组不良反应总发生率低于观察组(P>0.05)。结论rhTPO联合造血干细胞移植治疗AML可以缩短血小板重建时间和血小板恢复时间,增强凝血功能,缓解炎症反应,提高造血微环境的血流供应,安全性好。Objective To explore the effects of recombinant human thrombopoietin(rhTPO)combined with allogeneic hematopoietic stem cell transplantation(allo-HSCT)on platelet recovery in patients with acute myeloid leukemia(AML).Methods A total of 74 patients with AML admitted to the hospital were enrolled as the research objects from January 2020 to December 2021.They were randomly divided into control group(37 cases,allo-HSCT)and observation group(37 cases,rhTPO combined with allo-HSCT).After treatment,platelet reconstruction and recovery time,coagulation function indexes[prothrombin time(PT),fibrinogen(FIB),activated partial thrombopastin time(APTT)],inflammatory factors[procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)]and vascular indexes[vascular endothelial growth factor(VEGF),vascular endothelial growth factor C(VEGF-C)],and occurrence of adverse reactions during treatment were compared between the two groups.Results After treatment,platelet reconstruction and recovery time in observation group were shorter than those in control group(P<0.05).The levels of APTT and PT were lower in observation group than control group,while FIB was higher in observation group(P<0.05).The levels of PCT,CRP and IL-6 were lower in observation group than control group(P<0.05),while levels of VEGF and VEGF-C were higher in observation group(P<0.05).During treatment,total incidence of adverse reactions was lower in control group than observation group(P>0.05).Conclusion The rhTPO combined with hematopoietic stem cell transplantation can shorten platelet reconstruction and recovery time,enhance coagulation function,relieve inflammation response and improve blood supply of hematopoietic micro-environment in AML,with good safety.

关 键 词：重组人血小板生成素 造血干细胞移植 急性髓系白血病 血小板 

分 类 号：R556.5[医药卫生—血液循环系统疾病]