دورية أكاديمية
A multicenter study of romiplostim for chemotherapy-induced thrombocytopenia in solid tumors and hematologic malignancies.
العنوان: | A multicenter study of romiplostim for chemotherapy-induced thrombocytopenia in solid tumors and hematologic malignancies. |
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المؤلفون: | Al-Samkari H; Div of Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA., Parnes AD; Hematology Division, Brigham and Womens Hospital, Boston, USA., Goodarzi K; Div of Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA., Weitzman JI; Division of Hematology Oncology, Newton-Wellesley Hospital, Newton, USA., Connors JM; Hematology Division, Brigham and Women Hospital, Harvard Medical School, Boston, USA., Kuter DJ; Div of Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. |
المصدر: | Haematologica [Haematologica] 2021 Apr 01; Vol. 106 (4), pp. 1148-1157. Date of Electronic Publication: 2021 Apr 01. |
نوع المنشور: | Journal Article; Multicenter Study |
اللغة: | English |
بيانات الدورية: | Publisher: Ferrata Storti Foundation Country of Publication: Italy NLM ID: 0417435 Publication Model: Electronic Cited Medium: Internet ISSN: 1592-8721 (Electronic) Linking ISSN: 03906078 NLM ISO Abbreviation: Haematologica Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1999- : Pavia, Italy : Ferrata Storti Foundation Original Publication: Pavia [etc.] |
مواضيع طبية MeSH: | Antineoplastic Agents*/adverse effects , Hematologic Neoplasms*/drug therapy , Neoplasms*/complications , Neoplasms*/drug therapy , Thrombocytopenia*/chemically induced , Thrombocytopenia*/drug therapy, Humans ; Receptors, Fc/therapeutic use ; Recombinant Fusion Proteins/therapeutic use ; Retrospective Studies ; Thrombopoietin/therapeutic use |
مستخلص: | Chemotherapy-induced thrombocytopenia (CIT) frequently complicates cancer treatment causing chemotherapy delays, dose reductions, and discontinuation. There is no FDA-approved agent available to manage CIT. This study retrospectively evaluated patients with CIT treated on institutional romiplostim treatment pathways at 4 U.S. centers. The primary outcome was achievement of a romiplostim response [median on-romiplostim platelet count (Plt) ≥75x109/L and ≥30x109/L above baseline]. Secondary outcomes included time to Plt≥100x109/L and rates of the following: Plt<100x109/L, Plt<75x109/L, Plt<50x109/L, thrombocytosis, chemotherapy dose reduction/treatment delay, platelet transfusion, bleeding, and thromboembolism. Multivariable regression was used to identify predictors of romiplostim non-response and compare weekly dosing with intracycle/intermittent dosing. 173 patients (153 solid tumor, 20 lymphoma or myeloma) were treated, with 170 (98%) receiving a median of 4 (range, 1-36) additional chemotherapy cycles on romiplostim. Romiplostim was effective in solid tumor patients: 71% of patients achieved a romiplostim response, 79% avoided chemotherapy dose reductions/treatment delays and 89% avoided platelet transfusions. Median per-patient Plt on romiplostim was significantly higher than baseline (116x109/L vs. 60x109/L, P<0.001). Bone marrow tumor invasion, prior pelvic irradiation, and prior temozolomide predicted romiplostim non-response. Bleeding rates were lower than historical CIT cohorts and thrombosis rates were not elevated. Weekly dosing was superior to intracycle dosing with higher response rates and less chemotherapy dose reductions/treatment delays (IRR 3.00, 95% CI 1.30-6.91, P=0.010) or bleeding (IRR 4.84, 95% CI 1.18-19.89, P=0.029). Blunted response (10% response rate) was seen in non-myeloid hematologic malignancy patients with bone marrow involvement. In conclusion, romiplostim was safe and effective for CIT in most solid tumor patients. |
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المشرفين على المادة: | 0 (Antineoplastic Agents) 0 (Receptors, Fc) 0 (Recombinant Fusion Proteins) 9014-42-0 (Thrombopoietin) GN5XU2DXKV (romiplostim) |
تواريخ الأحداث: | Date Created: 20200606 Date Completed: 20210527 Latest Revision: 20210527 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC8018116 |
DOI: | 10.3324/haematol.2020.251900 |
PMID: | 32499239 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1592-8721 |
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DOI: | 10.3324/haematol.2020.251900 |