造血干细胞移植相关血小板减少是移植后常见的并发症之一,其病因复杂,尚无明确的治疗方法。重组人血小板生成素在移植前的动员阶段和移植后期均发挥作用,降低移植相关血小板减少发生的同时,减少了血小板的输注,表现出良好的安全性。本文将对重组人血小板生成素在移植前后的运用作一综述。
Transplant-associated thrombocytopenia is one of the common complications after transplantation, which has complicated etiology and doesn't have definite treatment. Recombinant human thrombopoietin plays an important role in both the mobilization stage before transplantation and the post-transplantation stage, improving the occurrence of transplant-related thrombocytopenia and reducing the transfusion of platelets. At the same time, it shows good safety. The application of recombinant human thrombopoietin before and after transplantation is reviewed in this paper.
重组人血小板生成素,移植相关血小板减少,造血干细胞移植, Recombinant Human Thrombopoietin Transplant-Associated Thrombocytopenia Hemopoietic Stem Cell Transplantation摘要
Transplant-associated thrombocytopenia is one of the common complications after transplantation, which has complicated etiology and doesn't have definite treatment. Recombinant human thrombopoietin plays an important role in both the mobilization stage before transplantation and the post-transplantation stage, improving the occurrence of transplant-related thrombocytopenia and reducing the transfusion of platelets. At the same time, it shows good safety. The application of recombinant human thrombopoietin before and after transplantation is reviewed in this paper.
Keywords:Recombinant Human Thrombopoietin, Transplant-Associated Thrombocytopenia, Hemopoietic Stem Cell Transplantation
王椿等 [28] 进行了一项多中心临床试验来评价使用血小板生成素联合化疗+G-CSF的动员方案治疗复发/难治性非霍奇金淋巴瘤,将78例一线治疗失败复发/难治的非霍奇金淋巴瘤患者在接受化疗后随机分成两组,结果显示TPO组CD34+细胞采集总数的中位数明显高于对照组CD34+细胞采集总数的中位数(6.35 × 106/kg vs 3.3 × 106/kg, P = 0.0054);同时,动员时达CD34+细胞最低目标数的比率增高(100% vs 86%, P = 0.035)。该研究发现,rhTPO在复发/难治的非霍奇金淋巴瘤患者的使用中CD34+细胞细胞产量增加近50%,是一种有效的动员增强剂。王国蓉等 [2] 在一项队列研究中对142名多发性骨髓瘤患者随机分成两组,其基线特征大致相同,研究结果显示,TPO组的成功率和理想率的优势比分别是91.7%和55.6%,明显高于非TPO组的55.6%和25.7%。总的来说,使用rhTPO联合中剂量CTX和G-CSF动员可以获得更高的干细胞产量。上述研究表明,rhTPO的使用可以提高CD34+细胞,同时,也提升了动员的成功率。
许 玥,刘 鹏,王彦丽,李 丽,接贵涛. 重组人血小板生成素在造血干细胞移植中应用的研究进展Progress in the Application of Recombinant Human Thrombopoietin in Hematopoietic Stem Cell[J]. 临床医学进展, 2021, 11(06): 2851-2856. https://doi.org/10.12677/ACM.2021.116414
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