Topical issues in the treatment of thrombocytopenia caused by chemotherapy: the view of a hematologist
Objective. Thrombocytopenia is a common complication of chemotherapy, which is characterized by a decrease in platelet count <150×10⁹/l duration. Early diagnosis and correction of thrombocytopenia are important points in the treatment of patients with cancer. Currently, thromboconcentrate transfusions, recombinant human thrombopoietin, and eltrombopag are used to treat thrombocytopenia.
Materials and methods. 200 patients were treated with recombinant human thrombopoietin in the hematology department from 2019 till 2020.
Results and discussion. Patients were divided into two groups. 150 patients received thrombopoietin to prevent predicted chemotherapy-induced thrombocytopenia at a dose of 300 IU/kg subcutaneously after 4 consecutive days. In 50 patients Rl-TPO was used for therapeutic purposes, in the presence of thrombocytopenia, at a dose of 300 IU/kg subcutaneously daily 10-14 consecutive injections. In the 1st study group, the level of platelets when using Rl-TPO according to the scheme did not decrease by less than 150×10⁹/l. In the 2nd group, the level of platelets from 50-65×10⁹/l when using thrombopoietin for therapeutic purposes in 87 % patients began to rise for 4-5 days after administration, normalized on day 12-13, in 13 % patients began to rise on day 7-8, normalized for 15-16 days.
Conclusions. Prevention of thrombocytopenia due to early administration of recombinant human thrombopoietin to the patient, rather than correction of pre-existing thrombocytopenia, can increase the effectiveness of chemotherapy through strict adherence to the schedule and recommended dosage, to avoid possible side effects directly from the patient.
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