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化疗引起的血小板减少症治疗共识中的差异。

Disparities in the consensus for treatment of chemotherapy-induced thrombocytopenia.

作者信息

Hambardzumyan Liana, Grigoryan Henrik, Badikyan Maria, Khachatryan Heghine, Sargsyan Nelly, Sulikhanyan Arliette, Tamamyan Gevorg, Stebbing Justin

机构信息

Hematology Center after Prof. R. H. Yeolyan, Yerevan 0014, Armenia.

Department of Surgery and Cancer, Imperial College, London SW7 2BX, UK.

出版信息

Ecancermedicalscience. 2023 Nov 13;17:1627. doi: 10.3332/ecancer.2023.1627. eCollection 2023.

Abstract

INTRODUCTION

Chemotherapy-induced thrombocytopenia (CIT) is an arduous complication of chemotherapy to be dealt with, and there are many unmet needs in this field to be addressed on the global front. We have conducted this study to contribute to the understanding of existing knowledge gaps of CIT management and highlight the direction to focus future investigations.

METHODS

This was an academic single-institution report on a cross-sectional study evaluating CIT management practices using platelet (PLT) transfusions by haematologists and oncologists in Armenia.

RESULTS

Physicians' opinions differed significantly when it came to defining thrombocytopenia by PLT levels. 13.2% of those surveyed considered thrombocytopenia to be when PLT counts fall below 180 × 10/L, 42.1% defined thrombocytopenia to have a PLT threshold of 150 × 10/L, 15.8% and 21.0% specialists setting their thresholds at 140 × 10/L and 100 × 10/L, respectively.All physicians managed CIT by performing PLT transfusions for prophylactic purposes (i.e., when PLT count falls below a certain threshold) with none of them transfusing PLTs only on-demand to address active bleeding. 73.3% haematologists (adult), 57.1% medical oncologists, and 50% paediatricians deemed 10 × 10/L as the threshold PLT count for transfusing afebrile patients with haematologic malignancies (besides acute promyelocytic leukaemia (APL)) and solid tumours.PLT products availability varied among the respondents, with only 53% of them responding that they had 24/7 access.

CONCLUSION

CIT is a complication of interest to physicians worldwide and has not been resolved yet. This is the first conducted survey regarding CIT and the initial step for further research.

摘要

引言

化疗引起的血小板减少症(CIT)是化疗过程中需要应对的一项棘手并发症,在全球范围内,该领域仍存在许多未满足的需求有待解决。我们开展这项研究,旨在促进对CIT管理现有知识空白的理解,并突出未来研究的重点方向。

方法

这是一份来自单一学术机构的报告,是一项横断面研究,评估了亚美尼亚血液科医生和肿瘤科医生使用血小板(PLT)输注进行CIT管理的实践情况。

结果

在通过PLT水平定义血小板减少症方面,医生们的意见存在显著差异。13.2%的受访者认为当PLT计数低于180×10⁹/L时为血小板减少症,42.1%将血小板减少症定义为PLT阈值为150×10⁹/L,分别有15.8%和21.0%的专家将阈值设定为140×10⁹/L和100×10⁹/L。所有医生都通过进行预防性PLT输注来管理CIT(即当PLT计数低于某个阈值时),没有人仅在有活动性出血时按需输注PLT。73.3%的血液科医生(成人)、57.1%的肿瘤内科医生和50%的儿科医生认为,对于患有血液系统恶性肿瘤(急性早幼粒细胞白血病(APL)除外)和实体瘤的无发热患者,10×10⁹/L是输注PLT的阈值计数。受访者中PLT产品供应情况各不相同,只有53%的人表示他们能够随时获取。

结论

CIT是全球医生关注的并发症,尚未得到解决。这是关于CIT的首次调查,也是进一步研究的第一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cc8/10898910/f74d2961a709/can-17-1627fig1.jpg

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