Clinical Analysis Of Recombinant Human Thrombopoietin In The Treatment Of Thrombocytopenia Induced By Chemotherapy In Children With Acute Lymphoblastic Leukemia

ObjectiveTo analyze the therapeutic effect and safety of recombinant human thrombopoietin(rhTPO)on chemotherapy induced thrombocytopenia(CIT)in children with acute lymphoblastic leukemia(ALL),and provide reference for the treatment of CIT in children.MethodsThe data was collected in children with ALL diagnosed by Morphology-Immunophenotype-Cytogenetics-Molecular Biology(MICM)and underwent combined chemotherapy in Ningxia Medical University Hospital from January 2016 to January 2019.A retrospective analysis was performed in cases who had a PLT count<50×10~9/L during a single chemotherapy cycle.A total of 60 patients with ALL were enrolled and platelet<50×10~9/L occurred in 153 after chemotherapy.The cases were divided into two groups according to the treatment of thrombocytopenia:Group A as treatment group(76 cases),with a median age of5(2-14)years,recombinant human thrombopoietin(rhTPO)was administer subcutaneously when PLT<50×10~9/L after chemotherapy and stopped when PLT rose to 75×10~9/L(the course of administration lesson longer than 2 weeks);group B as the control group(77 cases),with a median ageof 5(2-14)years old and rhTPO was not given.There were no significant differences in gender,age,weight,ethnicity,risk,and chemotherapy stage between the two groups(P>0.05).Leukocyte depleted PLT 1 unit was transfused and hemostatic drugs were given to children with bleeding tendency or PLT count<20×10~9/L,to prevent bleeding.The indications of transfusion were relaxed when there are risk factors such as high fever,hyperleukocytosis,rapid reduction of PLT,coagulopathy and critically ill children.PLT was measured every other day during the period of thrombocytopenia and PLT changes in the two groups within 21 days after platelet<50×10~9/L were compared:time of PLT increased to?50×10~9/L,?75×109/L and?100×109/L;hospitalization of single chemotherapy;highest PLT count;lowest PLT count;PLT transfusion frency;incidence of adverse reactions for PLT transfusion.Liver,renal function and coagulation function and incidence of adverse reactions before and after rhTPO administration in the treatment group were compared.Statistical analysis was performed using SPSS 21.0 statistical software.The measurement data was expressed as mean±standard deviation(?x±s)with using t test;enumeration data was expressed as rate(%)with?2 test.P<0.05 indicates statistically significant difference.Results1.The time of PLT increased to?50×10~9/L,?75×10~9/L and?100×10~9/L and hospitalization for single chemotherapy cycle in the treatment group were significantly shorter than in the control group(P<0.05).2.The highest PLT was significantly higher in the treatment than that in the control group(P<0.05).3.There was no significant difference in the lowest PLT count,PLT transfusion frequency,the incidence of adverse reaction of PLT transfusion between the treatment group and control group(P>0.05).4.No significant difference was found in liver function and coagulation function between the treatment group before and after rhTPO administration(P>0.05).5.Only 1 case(1.32%)had rash on the injection site after rhTPO subcutaneous administration,2 cases(2.63%)had low fever in the treatment group.The reactions were mild and tolerable and resoved without treatment.ConclusionrhTPO is effective and safe in the treatment of CIT in children with ALL and is worthy of clinical use.