罗普司亭用于消化系统肿瘤难治性化疗相关血小板减少的疗效与安全性分析OA

Objective To evaluate the efficacy and safety of romiplostim in the treatment of refractory chemotherapy-induced thrombocytopenia(CIT)in patients with digestive system malignancies.Methods A single-center retrospective study was performed.Forty patients with refractory CIT were enrolled at the Department of Gastrointestinal Oncology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from April 2025 to January 2026.All patients had previously received treatment with recombinant human interleukin-11,recombinant human thrombopoietin,or oral small-molecule thrombopoietin receptor agonists,yet exhibited inadequate platelet recovery.Romiplostim 250 μg was administered subcutaneously once weekly.The primary endpoint was the time to platelet count(PLT)recovery to≥75×109·L-1 or increase by≥50×109·L-1 relative to baseline.Secondary endpoints included the platelet response rate within 14 days and safety.Cox proportional hazards regression was used to analyze factors associated with the time to PLT recovery.Results The median time to PLT recovery was 10.0 days[95%CI＝(8.8,11.2)],and the overall response rate within 14 days was 82.5%(33/40).Multivariate analysis demonstrated that baseline PLT was an independent factor influencing the time to platelet recovery(HR＝2.468,P<0.05).Weight-based dose subgroup analysis showed that the median time to PLT recovery was 8 days in the>4 μg·kg-1 group and 10 days in the 2~4 μg·kg-1 group,indicating a trend toward faster onset of effect without statistical significance.There were no significant differences in efficacy or safety among different weight subgroups.Only 2 patients(5.0%)received platelet transfusion during treatment.No thrombotic events or drug-related adverse events occurred.Conclusion Romiplostim demonstrated promising efficacy and controllable safety in the treatment of refractory CIT in patients with digestive system malignancies,and baseline PLT may serve as an independent predictive indicator of treatment response..A higher dose of romiplostim shows a trend toward accelerated platelet recovery with manageable short-term safety.Romiplostim may be considered as a second-line treatment option for refractory CIT.