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  • Title: [Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China(2018)].
    Author: Consensus Committee of Chemotherapy Induced Thrombocytopenia, Chinese Society of Clinical Oncology.
    Journal: Zhonghua Zhong Liu Za Zhi; 2018 Sep 23; 40(9):714-720. PubMed ID: 30293399.
    Abstract:
    Chemotherapy induced thrombocytopenia (CIT) is a common side-effect of chemotherapy in cancer patients, which lead to dose and cycle reduction or chemotherapy delay, or even the need of platelet transfusion. Therefore, CIT significantly increases the cost of treatment, reduces the efficacy of chemotherapy and the quality of life, and shortens the survival time of patients. The main treatments of CIT include transfusion of platelets, recombinant human thrombopoietin (rhTPO), and recombinant human interleukin-11 (rhIL-11). RhIL-11 is the first approved thrombocytopoietic cytokine. Interleukin-11 has been shown to be effective in the treatment of thrombocytopenia. RhTPO is a recombinant full-length glycosylated thrombopoietin, which is a ligand for c-Mpl protein. Several observations indicated that administration of rhTPO before and after chemotherapy might be beneficial to patients, which enhances platelet recovery and reduces thrombocytopenia after moderately myelosuppressive regimens. In recent years, the application of rhTPO in CIT treatment has dramatically changed the management and treatment plan of CIT. The China Society of Clinical Oncology (CSCO) published a consensus on CIT in 2014. Based on this, the expert committee updated "Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China (2018)" according to the recent literature and clinical research. The new evidence-based practice consensus for CIT aims to provide more reasonable diagnosis, treatment of prevention regimens for CIT patients to maintain the normal platelet counts. 肿瘤化疗所致血小板减少症(CIT)是肿瘤化疗中常见的毒副反应，有可能导致化疗药物剂量降低或化疗时间延迟，甚至需要血小板输注，因而增加患者的治疗费用、降低化疗效果和患者的生活质量、缩短生存时间。CIT的主要治疗包括输注血小板、重组人血小板生成素(rhTPO)和重组人白细胞介素11(rhIL－11)。rhIL－11是最早上市的血小板生成细胞因子。IL－11已被证实对治疗血小板减少症有效。rhTPO是c－Mpl配体的一种重组形式，是全长糖化的TPO。rhTPO对化疗前和化疗后血小板增加均有效，能够在中度骨髓抑制方案后促进血小板恢复，并减少血小板减少症的发生。近年来，rhTPO在CIT治疗中的应用改变了CIT的诊疗方案。中国临床肿瘤学会CIT共识专家委员会根据CIT的诊疗情况制订了《肿瘤化疗所致血小板减少症诊疗中国专家共识(2014版)》。在此基础上，于2018年，专家委员会根据近期文献及临床研究更新为《肿瘤化疗所致血小板减少症中国专家共识(2018版)》，旨在为中国肿瘤学医师提供更合理的诊疗方案来帮助CIT患者维持正常血小板计数。.
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