肿瘤治疗所致血小板减少症诊疗进展OA
Advances in the diagnosis and treatment of cancer therapy-induced thrombocytopenia(CTIT)
肿瘤治疗所致血小板减少症(CTIT)在实体瘤中发生率约23％～30％,在血液肿瘤中发生率可达半数,严重影响抗肿瘤治疗进程.其机制包括化疗对巨核细胞的直接毒性、免疫介导的血小板破坏(如抗血小板糖蛋白抗体、T细胞失衡)及肿瘤微环境抑制等.治疗上,重组人血小板生成素(rhTPO)及血小板生成素受体激动剂(艾曲泊帕、罗普司亭、阿伐曲泊帕、海曲泊帕等)已显示良好疗效与安全性;二级预防及联合免疫调节策略(如低剂量地西他滨)为潜在方向.合并血栓或出血等特殊情境需个体化抗凝管理.未来需深入解析靶向治疗相关机制,推动专用药物研发.
Cancer therapy-induced thrombocytopenia(CTIT)occurs in approximately 23％-30％of solid tumors and up to half of hematologic malignancies,compromising anti-tumor treatment.Mechanisms include direct chemotherapy toxicity to megakaryocytes,immune-mediated platelet destruction(anti-platelet glycoprotein antibodies,T-cell dysregulation),and tumor microenvironment suppression.Recombinant human thrombopoietin(rhTPO)and thrombopoietin receptor agonists(eltrombopag,romiplostim,avatrombopag,hetrombopag)have demonstrated efficacy and safety.Secondary prophylaxis and combination immunomodulatory approaches(low-dose decitabine)are emerging.Individualized anticoagulation is required in special situations with concurrent thrombosis or bleeding.Further research is needed to elucidate targeted therapy-related mechanisms and develop dedicated drugs for CTIT.
丁冰洁;周虎
郑州大学附属肿瘤医院(河南省肿瘤医院)血液科,河南郑州 450008郑州大学附属肿瘤医院(河南省肿瘤医院)血液科,河南郑州 450008
医药卫生
肿瘤治疗所致血小板减少症化疗血小板生成素受体激动剂重组人血小板生成素二级预防免疫机制实体瘤
cancer therapy-induced thrombocytopeniachemotherapythrombopoietin receptor agonistrecombinant human thrombopoietinsecondary preventionimmune mechanismsolid tumor
《中国实用内科杂志》 2026 (7)
544-550,557,8
河南省自然科学基金(262300422263)同心家园"医心同航"医学研究项目
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