دورية أكاديمية
أعرض في EDS

A multicenter study of romiplostim for chemotherapy-induced thrombocytopenia in solid tumors and hematologic malignancies.

التفاصيل البيبلوغرافية
العنوان: A multicenter study of romiplostim for chemotherapy-induced thrombocytopenia in solid tumors and hematologic malignancies.
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
الوصف
تدمد:1592-8721
DOI:10.3324/haematol.2020.251900