Zhonghua Yi Xue Za Zhi. 2023 Sep 5;103(33):2579-2590. doi: 10.3760/cma.j.cn112137-20230409-00575.
Cancer treatment-induced thrombocytopenia (CTIT) is a common adverse event during anti-tumor treatment, of which incidence is related to tumor classification, regimens, course of chemotherapy, etc. CTIT may result in a series of events including bleeding, dose intensity reduction, chemotherapy delay, and in severe cases, even the need for platelet transfusion, ultimately affecting the implementation of treatment plan, increasing the cost of treatment, reducing treatment effect and quality of life, and leading to a poor prognosis. The treatment of CTIT should first identify the cause, assess the risk of bleeding, and then adopt treatment strategies according to the cause and severity of CTIT. The main treatments of CTIT include platelet transfusion, application of various types of platelet-producing drugs, and measures to reduce the additional loss of platelets. Among them, platelet-producing drugs mainly refer to platelet-stimulating factors, including recombinant human thrombopoietin (rhTPO), recombinant human interleukin 11(rhIL-11), and thrombopoietin receptor agonists (TPO-RAs). In addition, traditional Chinese medicine also has some assistance in raising platelets. Pharmacological prophylaxis in high-risk patients may help reduce the incidence and severity of CTIT. This consensus aims to support Chinese oncologists in the diagnosis and treatment of CTIT in China, reduce the risk of bleeding and improve the quality of life of patients.
癌症治疗引起的血小板减少症(CTIT)是抗肿瘤治疗期间常见的不良事件,其发生率与肿瘤分类、治疗方案、化疗疗程等有关。CTIT可能导致一系列事件,包括出血、剂量强度降低、化疗延迟,严重时甚至需要输注血小板,最终影响治疗计划的实施,增加治疗成本,降低治疗效果和生活质量,并导致预后不良。CTIT的治疗应首先明确病因,评估出血风险,然后根据CTIT的病因和严重程度采取治疗策略。CTIT的主要治疗方法包括血小板输注、应用各类促血小板生成药物以及减少血小板额外丢失的措施。其中,促血小板生成药物主要指血小板刺激因子,包括重组人血小板生成素(rhTPO)、重组人白细胞介素11(rhIL-11)和血小板生成素受体激动剂(TPO-RAs)。此外,中药在提升血小板方面也有一定辅助作用。对高危患者进行药物预防可能有助于降低CTIT的发生率和严重程度。本共识旨在支持中国肿瘤学家对中国CTIT的诊断和治疗,降低出血风险,提高患者生活质量。