罗普司亭治疗化疗相关性血小板减少症4例暨文献复习  

Romiplostim for the Treatment of Chemotherapy-Induced Thrombocytopenia:A Report of 4 Cases and Literature Review

作　　者：曾茜敏 李明[2] 张豪[2] 赵洁珺 席亚明[2] Zeng Qianmin;Li Ming;Zhang Hao;Zhao Jiejun;Xi Yaming(First Clinical Medical College,Lanzhou University,Lanzhou 730000,Gansu,China;Department of Hematology,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu,China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一医院血液科,兰州730000

出　　处：《肿瘤预防与治疗》2025年第3期231-236,共6页Journal of Cancer Control And Treatment

摘　　要：目的:探讨罗普司亭治疗肿瘤化疗相关性血小板减少症(chemotherapy-induced thrombocytopenia,CIT)的疗效及安全性。方法:收集4例应用罗普司亭治疗的难治肿瘤CIT患者的临床资料并复习相关文献。结果:4例患者均存在实体瘤化疗后反复出现血小板减少,前期使用白细胞介素-11或重组人促血小板生成素治疗后血小板计数可增加。后期化疗后出现血小板持续减少,上述治疗难以维持血小板计数,先后使用不同血小板生成素受体激动剂,最终使用罗普司亭治疗后血小板恢复正常。4例患者使用罗普司亭期间均未出现不良反应。复习相关文献,罗普司亭治疗CIT其作用机制尚不完全明确,AKT信号通路可能起到一定作用。推荐起始剂量为3μg/kg,最大给药量为10μg/kg,维持治疗可有效纠正CIT,使大多数患者恢复化疗。结论:罗普司亭治疗难治肿瘤CIT安全、有效,能迅速提高患者血小板水平。Objective:To evaluate the safety and efficacy of Romiplostim in the treatment of chemotherapy-induced thrombocytopenia(CIT).Methods:Clinical data from four patients with refractory CIT treated with Romiplostim were collected,and a review of relevant literature was conducted.Results:All four patients experienced recurrent thrombocytopenia following chemotherapy for solid tumors,and their platelet levels improved after treatment with interleukin-11 or recombinant human thrombopoietin.Following subsequent chemotherapy,platelet levels were difficult to maintain with the aforementioned treatments.Different thrombopoietin receptor agonists were tried successively,and platelet counts eventually normalized after treatment with Romiplostim.No adverse effects were observed in these four patients treated with Romiplostim.Based on a review of relevant literature,the mechanism of action of Romiplostim in treating CIT is not yet fully understood,although the AKT signaling pathway may play a role.The recommended starting dose is 3μg/kg,with a maximum dose of 10μg/kg.Maintenance therapy has been shown to effectively correct CIT,enabling most patients to resume chemotherapy.Conclusion:Romiplostim is safe and effective in treating refractory CIT and can rapidly increase platelet levels in patients.

关 键 词：化疗相关性血小板减少症 罗普司亭 疗效 

分 类 号：R558.2[医药卫生—血液循环系统疾病]