A real‐world observation on thrombopoietic agents for patients with cancer treatment–induced thrombocytopenia in China: A multicenter, cross‐sectional study

医学 中国 多中心研究 癌症 横断面研究 重症监护医学 内科学 病理 随机对照试验 政治学 法学
作者
Meiting Chen,Li Lu,Qing Xia,Xiaobing Chen,Zhijun Liao,Chang Wang,Bo Shen,Min Zhou,Qingyuan Zhang,Yanqiao Zhang,Qian Liu,Xianglin Yuan,Zhehai Wang,Cong Xue,Xin An,Yizhi Liu,Kangsheng Gu,Mingxiao Hou,Xiao-Jia Wang,Wei Wang,Enxiao Li,Jian Zhong,Jing Cheng,Yongqian Shu,Nong Yang,Huaqing Wang,Runxiang Yang,Tianshu Liu,Ting Deng,Fengyun Ma,Wangjun Liao,Wensheng Qiu,Yu Chen,Yong Bing Xiang,Mingzhi Zhang,Rui‐Hua Xu,Xiaoling Li,Jifeng Feng,Yi Ba,Yanxia Shi
出处
期刊:Cancer [Wiley]
卷期号:130 (S8): 1524-1538
标识
DOI:10.1002/cncr.35292
摘要

Studies on various thrombopoietic agents for cancer treatment-induced thrombocytopenia (CTIT) in China are lacking. This study aimed to provide detailed clinical profiles to understand the outcomes and safety of different CTIT treatment regimens.In this retrospective, cross-sectional study, 1664 questionnaires were collected from 33 hospitals between March 1 and July 1, 2021. Patients aged >18 years were enrolled who were diagnosed with CTIT and treated with recombinant interleukin 11 (rhIL-11), recombinant thrombopoietin (rhTPO), or a thrombopoietin receptor agonist (TPO-RA). The outcomes, compliance, and safety of different treatments were analyzed.Among the 1437 analyzable cases, most patients were treated with either rhTPO alone (49.3%) or rhIL-11 alone (27.0%). The most common combination regimen used was rhTPO and rhIL-11 (10.9%). Platelet transfusions were received by 117 cases (8.1%). In multivariate analysis, rhTPO was associated with a significantly lower proportion of platelet recovery, platelet transfusion, and hospitalization due to chemotherapy-induced thrombocytopenia (CIT) than rhIL-11 alone. No significant difference was observed in the time taken to achieve a platelet count of >100 × 109/L and chemotherapy dose reduction due to CIT among the different thrombopoietic agents. The outcomes of thrombocytopenia in 170 patients who received targeted therapy and/or immunotherapy are also summarized. The results show that the proportion of platelet recovery was similar among the different thrombopoietic agents. No new safety signals related to thrombopoietic agents were observed in this study. A higher proportion of physicians preferred to continue treatment with TPO-RA alone than with rhTPO and rhIL-11.This survey provides an overview of CTIT and the application of various thrombopoietic agents throughout China. Comparison of monotherapy with rhIL-11, rhTPO, and TPO-RA requires further randomized clinical trials. The appropriate application for thrombopoietic agents should depend on the pretreatment of platelets, treatment variables, and risk of bleeding.To provide an overview of the outcome of cancer treatment-induced thrombocytopenia in China, our cross-sectional study analyzed 1437 cases treated with different thrombopoietic agents. Most of the patients were treated with recombinant interleukin 11 (rhIL-11) and recombinant thrombopoietin (rhTPO). rhTPO was associated with a significantly lower proportion of platelet recovery and platelet transfusion compared with rhIL-11.

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