George Washington University, Washington, District of Columbia, USA
George Washington University, Washington, District of Columbia, USA.
BMJ Case Rep. 2020 Jun 30;13(6):e234584. doi: 10.1136/bcr-2020-234584.
Drug-induced thrombocytopenia (DITP) is suggested by severe thrombocytopenia with subsequent recovery of platelet count after removal of the offending drug. The diagnosis is ascertained when there is reproducibility of thrombocytopenia with repeated exposure. Filgrastim is used during peripheral blood progenitor cell harvest during autologous stem cell transplantation in the setting of multiple myeloma to prolong event-free survival and overall mortality. The following case illustrates all of the suggestive features of DITP after filgrastim exposure during elective stem cell harvest. Due to the inability to tolerate filgrastim, autologous stem cell transplant was aborted in this patient and he was maintained on induction chemotherapy.
药物诱导的血小板减少症（DITP）的特征是严重血小板减少症，随后在停用致病药物后血小板计数恢复。当反复暴露于药物时出现血小板减少症的可重复性时，即可确诊。在多发性骨髓瘤患者的自体干细胞移植中，使用粒细胞集落刺激因子（filgrastim）在外周血造血祖细胞采集期间，以延长无事件生存和总死亡率。以下病例说明了在选择性干细胞采集期间使用粒细胞集落刺激因子（filgrastim）后，所有提示 DITP 的特征。由于不能耐受粒细胞集落刺激因子（filgrastim），该患者的自体干细胞移植被取消，他继续接受诱导化疗。
