Liu Xiaofan, Huang Yueting, Liu Wei, Chen Yunfei, Xue Feng, Zhang Lei, Yang Renchi
Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2015 Apr;36(4):312-5. doi: 10.3760/cma.j.issn.0253-2727.2015.04.011.
To evaluate the efficacy of recombinant human thrombopoietin (rhTPO) and related factors which influencing the therapeutic effect in adults with severe immune thrombocytopenia (ITP).
The efficacy of rhTPO in 92 hospitalized adult patients [35 males and 57 females, median age as 34 (18-65) years] with severe ITP, including 7 cases of newly diagnosed ITP, 29 cases of persistent ITP and 56 cases of chronic ITP from May 2012 to May 2014 was retrospectively investigated. All patients received subcutaneous rhTPO, the injected dosage was 300 U·kg⁻¹·d⁻¹ for 14 days, platelet counts were recorded and followed-up for a week.
The overall response rate of rhTPO treatment was 60.9%. The overall response rates in newly diagnosed, persistent and chronic ITP were 71.4%, 62.1% and 58.9% respectively. The median platelet counts on fourth，seventh, fourteenth days of treatment, and the seventh day of withdrawal were 27(5-49), 65(16-138), 133(28-208) and 67(15-134)×10⁹/L, respectively. The median time was 6(5-7) days when platelet counts reached 100×10⁹/L, the median peak time was 11(5-17) days, the median maximum peak of platelet counts was 194(132-274)×10⁹/L in patients who reached CR after treatment. Related factors which affected therapeutic effect were analyzed in patients who reached CR after treatment, and indicated that sex, age, disease stage, express of platelet membrane glycoprotein (GP) and relative number of CD19+ B, CD3+CD4+ T, CD3+CD8+ T lymphocyte in blood samples did not influence the probability of complete response (P>0.05). A few patients with fever, muscle aches, fatigue or dizziness could be self-recovery without special intervention.
Severe ITP in adults treated by rhTPO had satisfactory therapeutic effect and safety.
评估重组人血小板生成素（rhTPO）治疗成人重型免疫性血小板减少症（ITP）的疗效及影响疗效的相关因素。
回顾性分析2012年5月至2014年5月期间收治的92例成人重型ITP患者[男35例，女57例，中位年龄34（18 - 65）岁]的临床资料，其中新诊断ITP 7例，持续性ITP 29例，慢性ITP 56例。所有患者均接受皮下注射rhTPO，剂量为300 U·kg⁻¹·d⁻¹，连用14天，记录血小板计数并随访1周。
rhTPO治疗的总有效率为60.9%。新诊断、持续性及慢性ITP患者的总有效率分别为71.4%、62.1%和58.9%。治疗第4天、第7天、第14天及停药后第7天的血小板计数中位数分别为27（5 - 49）、65（16 - 138）、133（28 - 208）和67（15 - 134）×10⁹/L。血小板计数达到100×10⁹/L的中位时间为6（5 - 7）天，中位峰值时间为11（5 - 17）天，治疗后达到完全缓解（CR）患者的血小板计数最大峰值中位数为194（132 - 274）×10⁹/L。对治疗后达到CR的患者分析影响疗效的相关因素，结果显示性别、年龄、疾病分期、血小板膜糖蛋白（GP）表达及血样中CD19⁺B、CD3⁺CD4⁺T、CD3⁺CD8⁺T淋巴细胞相对数均不影响完全缓解概率（P>0.05）。少数患者出现发热、肌肉酸痛、乏力或头晕，可自行恢复，无需特殊干预。
rhTPO治疗成人重型ITP疗效及安全性良好。
