摘要
目的:探讨司坦唑醇联合阿伐曲泊帕治疗复发难治性肿瘤化疗相关血小板减少症(CIT)的疗效和安全性。方法:选取2023年3月至2023年12月中国中医科学院西苑医院血液科门诊收治的符合复发难治性CIT标准的25例患者,采用司坦唑醇联合阿伐曲泊帕的治疗方案,并评价该方案的临床疗效、起效时间、治疗前后血小板水平、血细胞计数变化和不良反应。结果:司坦唑醇联合阿伐曲泊帕治疗CIT的疗效显著,总有效率为100%。25例患者中19例完全缓解,6例获得部分缓解。中位起效时间为42.5(35-48)d。治疗前25例患者血小板平均水平为(25.73±17.75)×10^(9)/L,治疗3个月后血小板计数显著上升至(146.4±49.59)×10^(9)/L,差异有统计学意义(P<0.05)。18例患者治疗前曾需血小板输注维持,3个月治疗后均脱离血小板输注,脱离血小板输注的中位时间为26(18-51)d。治疗期间中性粒细胞和血红蛋白均有不同程度的升高。2例患者治疗期间出现谷丙转氨酶轻度升高,予以口服保肝药物治疗后恢复正常,1例患者PLT升高超过350×10^(9)/L,暂停使用阿伐曲泊帕治疗,同时给予阿司匹林等药物预防血栓形成。所有患者均未发现血栓相关事件及CIT相关出血事件。结论:司坦唑醇联合阿伐曲泊帕治疗复发难治性CIT患者疗效显著,有效率高且安全性良好,可作为临床合适的治疗选择。
Objective:To investigate the efficacy and safety of stanozolol combined with avatrombopag in the treatment of chemotherapy-induced thrombocytopenia(CIT)in patients with relapsed/refractory tumors.Methods:Twenty-five patients with relapsed/refractory CIT admitted to the Hematology Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences between March 2023 to December 2023 were enrolled.These patients received a combined therapy of stanozolol and avatrombopag.The clinical efficacy,onset time,changes in platelet levels and blood cell counts before and after treatment,and adverse reactions of patients were evaluated.Results:The combination therapy demonstrated remarkable efficacy with a total effective rate of 100%.Among the 25 patients,19 achieved complete remission and 6 achieved partial remission.The median onset time was 42.5(range:35-48)days.The average platelet count of the 25 patients increased from(25.73±17.75)×10^(9)/L before treatment to(146.4±49.59)×10^(9)/L after 3 months of treatment,with a statistically significant difference(P<0.05).18 patients who previously required platelet transfusion were all weaned off platelet transfusion after 3 months of treatment,with a median time to be free from platelet transfusion was 26(range:18-51)days.During the treatment,both neutrophils and hemoglobin exhibited various degrees of elevation.Two patients experienced a slight increase in alanine aminotransferase(ALT)levels,which normalized after treatment with oral hepatoprotective drug.One patient had a PLT increase exceeding 350×10^(9)/L,and the treatment with avatrombopag was suspended,and aspirin and other drugs were given to prevent thrombosis.No thrombose events or CIT-related bleeding events were observed in all patients.Conclusion:The combination therapy of stanozolol and avatrombopag is significantly effective for treating relapsed/refractory CIT patients,with a high response rate and good safety,making it a suitable clinical treatment option.
作者
贺妍
刘为易
张延宇
吕妍
张姗姗
全日城
HE Yan;LIU Wei-Yi;ZHANG Yan-Yu;LYU Yan;ZHANG Shan-Shan;QUAN Ri-Cheng(Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国实验血液学杂志》
北大核心
2025年第4期1127-1130,共4页
Journal of Experimental Hematology
基金
国家重点基础研究发展计划(973计划)(2015CB554403)。
作者简介
通信作者:全日城,主任医师,E-mail:quanrc@126.com。
