Retrospective study of TACE in the treatment of lobaplatin-induced thrombocytopenia in primary hepatocellular carcinoma.

PURPOSE

To discuss postoperative thrombocytopenia in the treatment of hepatocellular carcinoma (HCC) through transcatheter arterial chemoembolization (TACE) with single application of Lobaplatin as chemotherapy drug.

METHODS

The study retrospectively analyzed 1,945 HCC patients treated with TACE in our hospital from May 2013 to May 2018. The number of first-time users of lobaplatin reached 128, the second-time users reached 417, the third-time and above users 239. The analysis examined various items of patients, including gender, age, multiple preoperative examination indicators (platelet level, liver function tests, AFP level), ascites, preoperative presence of peptic ulcer at the initial (3-7 days) and long-term (21-90 days) postoperative stages. Platelet levels were evaluated according to the WHO Grading System for Hematologic Toxicity for side effects of anticancer drugs.

RESULTS

For HCC patients with normal pre-intervention platelet level, the incidences of mild decrease, moderate decrease and severe decrease after intervention were 16.50%, 10.47% and 4.88% respectively, the incidences of long-term platelet reduction after intervention were 13.25%, 4.73% and 1.65% respectively. The level of post-intervention thrombocytopenia was not correlated with the cycles of lobaplatin use. The initial thrombocytopenia was more obvious in female patients after intervention. The presence or absence of peptic ulcer and ascites before the intervention had an effect on the initial thrombocytopenia after the intervention. Platelet level before intervention was correlated with that after intervention. The liver function grading before intervention had no effect on the two levels of thrombocytopenia after intervention. There was a correlation between AFP level grouping before intervention and initial thrombocytopenia after intervention.

CONCLUSIONS

The long-term incidence of thrombocytopenia after interventional therapy was not high in TACE patients with HCC treated with LPT alone, which was relatively safe. Besides, the occurrence of thrombocytopenia after intervention had certain characteristics, which can be used to guide clinical practice, so as to reduce the incidence of thrombocytopenia or provide targeted symptomatic support treatment.