促血小板生成药物在化疗相关性血小板减少症中的治疗进展

苏 梦梦, 焦 小雯, 石 雨薇
新疆医科大学第二附属医院，新疆，乌鲁木齐 830000

摘要

目的：化疗相关性血小板减少症(CIT)是常见的肿瘤化疗后血液毒副作用，及时、有效地提升血小板数目，降低患者发生不良预后的风险，提高患者的中位生存期是当前治疗的目标。因此寻求有效应对CIT的治疗方法已经成为临床亟待解决的问题。本文重点对促血小板生成类药物在CIT患者中的应用进展进行综述，以期为临床治疗CIT提供参考依据。

关键词

化疗相关血小板减少症；促血小板生成药；重组人白细胞介素-11；重组人血小板生成素；血小板生成素受体激动剂

参考

[1]Moik Florian,Makatsariya Alexander,Ay Cihan.Challenging anticoagulationcases: Cancer-associated venous thromboembolism and chemotherapy-induced thrombocytopenia–A case-based reviewof clinicalmanagement[J].Thrombosis Research,2021,199.[2]中国抗癌协会肿瘤临床化疗专业委员会,中国抗癌协会肿瘤支持治疗专业委员会.中国肿瘤化疗相关性血小板减少症专家诊疗共识(2019版)[J].中国肿瘤临床,2019,46(18):923-929.[3]WEYCKER D,HATFIELD M,GROSSMAN A,et al.Risk and consequences of chemotherapy-induced thrombocytopenia in US clinical practice[J].BMC Cancer, 2019, 19(1):151-158.[4]Schmied Laurent,Höglund Petter,Meinke Stephan.Platelet-Mediated Protection of Cancer Cells From Immune Surveillance–Possible Implications for Cancer Immunotherapy[J].Frontiers in Immuno logy,2021,12.[5]Xu Y,Song X,Du F,Zhao Q,Liu L,Ma Z,Lu S.A Randomized Controlled Study of rhTPO and rhIL-11for the Prophylactic Treatment of Chemotherapy-Induced Thrombocytopenia in Non-Small Cell Lung Cancer[J].Journal of Cancer,2018,9(24):4718-4725.[6]中国抗癌协会肿瘤临床化疗专业委员会,中国抗癌协会肿瘤支持治疗专业委员会.中国肿瘤化疗相关性血小板减少症专家诊疗共识(2019 版)[J].中国肿瘤临床，2019,18(46):923-929.[7]李亮,孔春芳,金成豪.血液系统肿瘤中化疗相关血小板减少的机制研究进展[J].中国比较医学杂志,2023,33(02):113-118.[8]中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016 年版)[J].中华血液学杂志,2016,37(20):89-93.Liu NW,Huang X,Liu S,Liu WJ,Wang H,Wang WD,Lu Y.Elevated BNP caused by recombinant human interleukin-11 treatment in patients with chemotherapy-induced thrombocytopenia[J].SupportCare Cancer,2019,27(11):4293-4298.[9]Thrombopoietin receptor agonist switch in adult primary immune thrombocytopeniapatients:A retrospective collaborative survey involving 4 Spanish centres[J].European journal of haematology,2017,99(4):372-377.[10]XU Y,SONG X,DU F,et al.A Randomized Controlled Study of rhTPO and rhIL-11 for the Prophylactic Treatment of Chemotherapy-Induced Thrombocytopenia in Non-Small Cell Lung Cancer[J].Journal of Cancer,2018,9(24):4718-4725.[11]BasserRL,O’FlahertyE,GreenM,et al.Development of pancytopenia with neutralizing antibodies to thrombopoietin after multicycle chemotherapy supported by megakaryocyte growth and development factor[J].Blood,2002,99(7):2599-2602.[12]DeOliveiraBQ,CattoLFB,SantanaBAA,etal.Eltrombopagpreferentiallyexpandshaematopoieticmultipotentprogenitorsinhumanaplasticanaemia[J].BrJHaematol,2021,193(2):410-414.[13]Desmond R,Townsley DM,Dumitriu B,et al.Eltrombopag restores trilineage hematopoiesis in refractory severe aplastic anemia that can be sustained on discontinuation of drug[J]. Blood ,2014,123(12):1818–1825.[14]Bussel JB,Soff G,Balduzzi A,Cooper N,Lawrence T,Semple JW.A Review ofRomiplostim Mechanism of Action and Clinical Applicability[J].Drug Des Devel Ther,2021,26,15:2243-2268.[15]Bussel J,Kulasekararaj A,Cooper N,Verma A,Steidl U,Semple JW,Will B.Mechanisms and therapeutic prospects of thrombopoietin receptor agonists[J].Semin Hematol,2019,56(4):262-278.[16]Kapur R,Aslam R,Speck ER,Rebetz JM,Semple JW.Thrombopoietin receptor agonist (TPO-RA) treatment raises platelet counts and reduces anti-platelet antibodylevels in mice with immune thrombocytopenia (ITP)[J].Platelets,2020,31(3):399-402.[17]Erhardt JA,Erickson-Miller CL,Aivado M.et al.Comparative analyses of the small molecule thrombopoietin receptor agonist eltrombopag and thrombopoietin on in Vitro platelet function[J].Exp Hematol,2009,37(9):1030-1037.[18]齐彦,廖斌,陈泽松等.艾曲波帕联合 rhTPO 治疗血液肿瘤化疗所致血小板减少症的疗效[J].深圳中西医结合杂志,2022, 32(12):93-96.[19]Ghanima W,Cooper N,Rodeghiero F,et al.Thrombopoietin receptor agonists:ten years later[J]. Haematologica,2019, 104(6):1112-1123.[20]Pulani ć Dra ž en,Bátorová Angelika,Bodó Imre, Č ervinek Libor,Ionita Ioana,LissitchkovToshko,Melikyan Anahit,PodolakDawidziak Maria.Use of thrombopoietin receptor agonists in adults with immune thrombocytopenia:a systematic review and CentralEuropean expert consensus[J].Annals of hematology,2023,102(4):715-727[21]马明瑛,王军旗,张治业.海曲泊帕乙醇胺片联合重组人血小板生成素对实体肿瘤治疗相关性血小板减少症的疗效及对血清TPO、IL-6、TNF-α水平的影响[J].药物评价研究,2023,46(04):843-849.