重组人血小板生成素对多发性骨髓瘤患者化疗后血小板恢复的影响  

Effect of recombinant human thrombopoietin on platelet recovery in patients with multiple myeloma after chemotherapy

作　　者：李可芯 赵薇薇 刘瑶[1] 高新宇[1] 王连杰[1] 周芳卉 常玉莹[1] 刘娟[1] 陈丽艳[1] 王巍[1] LI Ke-xin;ZHAO Wei-wei;LIU Yao;GAO Xin-yu;WANG Lian-jie;ZHOU Fang-hui;CHANG Yu-ying;LIU Juan;CHEN Li-yan;WANG Wei(Department of Hematology,The Second Affiliated Hospital of Harbin Medical University,Har-bin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院血液内科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2024年第1期10-14,共5页Journal of Harbin Medical University

基　　金：湖北陈孝平科技发展基金会青年科学专项基金(CXPJJH121003-2121)。

摘　　要：目的分析重组人血小板生成素(recombinant human thrombopoietin,rhTPO)促进多发性骨髓瘤(multiple myeloma,MM)患者化疗后血小板(platelet,PLT)恢复的疗效及安全性。方法收集2021年6月~2022年12月62例接受化疗后30 d内发生肿瘤化疗相关性血小板减少症(chemotherapy-associated thrombocytopenia,CIT)的MM患者进行回顾性分析。根据化疗后重组人血小板生成素使用情况将62例患者分为rhTPO组(30例)和对照组(32例),rhTPO组PLT<100×10^(9)/L时,每天皮下注射rhTPO 1500 U,总计注射14天或PLT恢复至100×10^(9)/L时停用;对照组不应用升血小板药物,仅进行支持治疗。比较两组CIT的分级、血小板恢复情况以及化疗期间血小板输注量,观察药物的不良反应。结果rhTPO组和对照组比较,治疗前PLT差异无统计学意义(P>0.05),PLT≥25×10^(9)/L的恢复时间差异亦无统计学意义(P>0.05);但rhTPO组的PLT≥50×10^(9)/L的恢复时间、PLT≥100×10^(9)/L的恢复时间均较对照组短,治疗后PLT明显高于对照组,血小板输注量低于对照组,差异均具有统计学意义(P<0.05)。rhTPO组疗效为83.3%,所有患者PLT均恢复至25×10^(9)/L以上,未达到PLT≥50×10^(9)/L的患者2例;对照组疗效为78.1%,所有患者PLT均恢复至25×10^(9)/L以上,未达到PLT≥50×10^(9)/L的患者3例。rhTPO组未见明显不良反应。结论rhTPO可促进MM患者化疗后血小板恢复、减少血小板输注量,并且安全性较好。Objective To analyze the efficacy and safety of recombinant human thrombopoietin(recombinant human thrombopoietin,rhTPO)in promoting platelet(PLT)recovery after chemotherapy in patients with multiple myeloma(MM).Methods A retrospective analysis was performed on 62 MM patients who developed chemotherapy⁃associated thrombocytopenia(CIT)within 30 days after chemotherapy from June 2021 to December 2022.According to the use of recombinant human thrombopoietin after chemotherapy,62 patients were divided into rhTPO group(30 cases)and control group(32 cases).The grade of CIT,platelet recovery,platelet transfusion volume during chemotherapy and adverse drug reactions were compared between the two groups.Results There was no significant difference in platelet count before treatment be⁃tween rhTPO group and control group(P>0.05),and there was no significant difference in the recovery time of PLT count≥25×10^(9)/L(P>0.05).However,the recovery time of PLT≥50×10^(9)/L and PLT≥100×10^(9)/L in the rhTPO group were shorter than those in the control group,the PLT after treatment was significantly higher than that in the control group,and the platelet transfusion volume was lower than that in the control group,the differences were statis⁃tically significant(P<0.05).The response rate of rhTPO group was 83.3%,PLT of all pa⁃tients recovered to more than 25×10^(9)/L,and 2 patients did not reach PLT≥50×10^(9)/L.In the control group,the response rate was 78.1%.PLT recovered to more than 25×10^(9)/L in all patients,and did not reach PLT≥50×10^(9)/L in 3 patients.No significant adverse reactions were observed in rhTPO group.Conclusion rhTPO can promote platelet recovery and reduce platelet transfusion in MM patients after chemotherapy with good safety.

关 键 词：多发性骨髓瘤 重组人血小板生成素 化疗 血小板输注 化疗相关性血小板减少症 

分 类 号：R733.3[医药卫生—肿瘤]