Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Biochemistry, Thrombosis and Hemostasis Research Unit, Aarhus University Hospital, Aarhus, Denmark.
Br J Cancer. 2024 May;130(9):1485-1492. doi: 10.1038/s41416-024-02630-w. Epub 2024 Mar 6.
Knowledge about thrombocytopenia among patients with solid tumors is scarce. We examined the risk of thrombocytopenia among patients with solid tumors and its association with adverse outcomes.
Using Danish health registries, we identified all patients with incident solid tumors from 2015-2018 (n = 52,380) and a platelet count measurement within 2 weeks prior to or on their cancer diagnosis date. The risk of thrombocytopenia was categorized as grades 0 (any platelet count × 10/L): <150; 1: <100; 2: <75; 3: <50; 4: <25, and 5: <10. To study the outcomes, each patient with thrombocytopenia was matched with up to five cancer patients without thrombocytopenia by age, sex, cancer type, and stage. Cox regression was used to compute hazard ratios (HRs) of bleeding, transfusion, or death, adjusting for confounding factors.
The 1-year risk of thrombocytopenia was 23%, increasing to 30% at 4 years. This risk was higher in patients receiving chemotherapy (43% at 1 year and 49% at 4 years). Overall, patients with thrombocytopenia had higher 30-days rates of bleeding (HR = 1.72 [95% confidence interval, CI: 1.41-2.11]). Thrombocytopenia was also associated with an increased rate of transfusion, and death, but some of the risk estimates were imprecise.
The risk of thrombocytopenia was substantial among patients with solid tumors and associated with adverse outcomes.
实体瘤患者的血小板减少症知识有限。我们研究了实体瘤患者发生血小板减少症的风险及其与不良结局的关系。
我们使用丹麦健康登记处，确定了 2015-2018 年所有新发实体瘤患者（n=52380），并在癌症诊断前 2 周内或当天进行了血小板计数测量。血小板减少症的风险分为以下等级：0 级（任意血小板计数×10/L）：<150；1 级：<100；2 级：<75；3 级：<50；4 级：<25；5 级：<10。为了研究结局，对每个有血小板减少症的患者，根据年龄、性别、癌症类型和分期，匹配了最多 5 名无血小板减少症的癌症患者。使用 Cox 回归计算出血、输血或死亡的风险比（HR），并调整混杂因素。
1 年内发生血小板减少症的风险为 23%，4 年内增加到 30%。接受化疗的患者风险更高（1 年内为 43%，4 年内为 49%）。总体而言，有血小板减少症的患者 30 天内出血的发生率较高（HR=1.72[95%置信区间，CI：1.41-2.11]）。血小板减少症还与输血和死亡的发生率增加有关，但一些风险估计值不太准确。
实体瘤患者发生血小板减少症的风险较高，并与不良结局相关。
