Clinical study on recombinant human thrombopoietin in the treatment of severe thrombocytopenia induced by chemotherapy in elder patients with acute myeloid leukemia

Abstract

Objective To study the efficacy and safety of recombinant human thrombopoietin (rhTPO)in the treatment of thrombocytopenia induced by chemotherapy in elder patients with acute myeloid leukemia. Methods 20 elder patients with acute myeloid leukemia who got CR received two cycles of consolidation chemotherapy. In the first cycle of chemotherapy(control cycle), they were transfused with platelet suspensions when they developed severe thrombocytopenia; In the second cycle of chemotherapy (treatment cycle), they were given subcutaneous injection of rhTPO 1.0μg·kg-2·d-1 for 14 days or until platelet count≥ 80×109/L with the treatment above all when platelet count ≤50×109/L. The efficacy and safety were evaluated. Results The duration of Plt count<100×109/L in the treatment cycle and the control cycle was (23.1±4.5)d and (25.8±5.7) d (P<0.005); the duration of Plt count≤20×109/L in the treatment cycle and in the control cycle was (6.8±2.6) d and (11.7±3.2) d (P<0.005). The minimal Plt count of the treatment cycle and the control cycle were (13.2±4.4)×109/L and (12.2±3.1)×109/L (P＝0.0967) respectively, and the maximal Plt count after its recovery were (239.3±48.7)×109/L and (163.5±32.4)×109/L (P<0.005) respectively. Platelet transfusion was (22.8±6.8) U in the treatment group, it was significantly lower than that in the control group (30.0±6.3) U (P<0.05).The changes of hemoglobin content, white blood cell count, Urine routine, the function of liver and kidney, the function of blood coagulation after chemotherapy in both groups were no obvious(P ＝0.0872). Transient adverse reaction was observed in 5 patients (25 %). No thrombotic incident had occurred. Conclusion rhTPO can significantly accelerate PLT recovery, reduce the degree and duration of thrombocytopenia induced by chemotherapy, and reduce platelet transfusion in the treatment of consolidation chemotherapy for the elder patients with acute myeloid leukemia. It is safe and can be recommended to use widely. Key words: Leukemia, myeloid, acute;  Aged;  Thrombopoietin;  Drug therapy, combination; Thrombocytopenia