Saroj Vadhan-Raj, MD; Claire F. Verschraegen, MD; Carlos Bueso-Ramos, MD; Hal E. Broxmeyer, PhD; Andrzej P. Kudelka, MD; Ralph S. Freedman, MD, PhD; Creighton L. Edwards, MD; David Gershenson, MD; Dennie Jones, MD; Mark Ashby, PhD; John J. Kavanagh, MD
Vadhan-Raj S, Verschraegen CF, Bueso-Ramos C, Broxmeyer HE, Kudelka AP, Freedman RS, et al. Recombinant Human Thrombopoietin Attenuates Carboplatin-Induced Severe Thrombocytopenia and the Need for Platelet Transfusions in Patients with Gynecologic Cancer. Ann Intern Med. 2000;132:364-368. doi: 10.7326/0003-4819-132-5-200003070-00005
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Published: Ann Intern Med. 2000;132(5):364-368.
Thrombocytopenia is a significant problem in the treatment of cancer.
To assess the clinical safety of therapy with recombinant human thrombopoietin (rhTPO) and its ability to ameliorate chemotherapy-induced severe thrombocytopenia.
Phase I/II clinical cohort study.
The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
29 patients with gynecologic cancer.
Recombinant human thrombopoietin was given before chemotherapy and after a second cycle of carboplatin therapy.
Peripheral blood counts and platelet transfusions.
Administration of rhTPO after chemotherapy significantly reduced the degree and duration of thrombocytopenia and enhanced platelet recovery. In patients who received the optimal biological dose of rhTPO (1.2 Âµg/kg of body weight) in cycle 2 (carboplatin plus rhTPO), the mean platelet count nadir was higher (44 Ã— 109 cells/L and 20 Ã— 109 cells/L; PÂ =Â 0.002) and the duration of thrombocytopenia was shorter (days with a platelet countÂ <20 Ã— 109 cells/L, 1 and 4 [PÂ =Â 0.002]; days with a platelet countÂ <50 Ã— 109 cells/L, 4 and 7 [PÂ =Â 0.006]) than in cycle 1 (carboplatin only). The need for platelet transfusion in this group was reduced from 75% of patients in cycle 1 to 25% of patients in cycle 2 (PÂ =Â 0.013).
Therapy with rhTPO seems to be safe and may attenuate chemotherapy-induced severe thrombocytopenia and reduce the need for platelet transfusions.
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Hematology/Oncology, Platelet Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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