Kos Marek, Tomaka Piotr, Mertowska Paulina, Mertowski Sebastian, Wojnicka Julia, Błażewicz Anna, Grywalska Ewelina, Bojarski Krzysztof
Department of Public Health, Medical University of Lublin, 20-400 Lublin, Poland.
Department of Anesthesiology and Intensive Care, SP ZOZ in Łęczna, 21-010 Łęczna, Poland.
J Clin Med. 2024 Nov 8;13(22):6738. doi: 10.3390/jcm13226738.
The pathogenesis of immune thrombocytopenia (ITP) is complex and involves the dysregulation of immune cells, such as T and B lymphocytes, and several cytokines that promote the production of autoantibodies. In the context of cancer patients, ITP can occur in both primary and secondary forms related to anticancer therapies or the disease itself.
In light of these data, we decided to prepare a literature review that will explain the classification and immunological determinants of the pathogenesis of ITP and present the clinical implications of this condition, especially in patients with cancer.
We reviewed the literature on immunological mechanisms, therapies, and challenges in treating ITP, particularly on cancer patients.
The results of the literature review show that ITP in cancer patients can be both primary and secondary, with secondary ITP being more often associated with anticancer therapies such as chemotherapy and immunotherapy. Innovative therapies such as TPO-RA, rituximab, Bruton's kinase inhibitors, and FcRn receptor inhibitors have shown promising results in treating refractory ITP, especially in patients with chronic disease.
ITP is a significant clinical challenge, especially in the context of oncology patients, where both the disease and treatment can worsen thrombocytopenia and increase the risk of bleeding complications. Treatment of oncology patients with ITP requires an individualized approach, and new therapies offer effective tools for managing this condition. Future research into immunological mechanisms may bring further advances in treating ITP and improve outcomes in cancer patients.
免疫性血小板减少症（ITP）的发病机制复杂，涉及免疫细胞（如T和B淋巴细胞）的失调以及多种促进自身抗体产生的细胞因子。在癌症患者中，ITP可原发性和继发性形式出现，与抗癌治疗或疾病本身相关。
鉴于这些数据，我们决定撰写一篇文献综述，解释ITP发病机制的分类和免疫决定因素，并阐述这种情况的临床意义，特别是在癌症患者中。
我们回顾了关于ITP免疫机制、治疗方法及治疗挑战的文献，特别是针对癌症患者的文献。
文献综述结果表明，癌症患者中的ITP可为原发性和继发性，继发性ITP更常与化疗和免疫治疗等抗癌治疗相关。TPO-RA、利妥昔单抗、布鲁顿激酶抑制剂和FcRn受体抑制剂等创新疗法在治疗难治性ITP方面已显示出有前景的结果，尤其是在慢性病患者中。
ITP是一项重大的临床挑战，特别是在肿瘤患者中，疾病和治疗均可使血小板减少症恶化并增加出血并发症的风险。治疗肿瘤合并ITP的患者需要个体化方法，新疗法为管理这种情况提供了有效的工具。未来对免疫机制的研究可能会在ITP治疗方面带来进一步进展，并改善癌症患者的治疗结果。
