Recombinant Human Thrombopoietin Attenuates Carboplatin-Induced Severe Thrombocytopenia and the Need for Platelet Transfusions in Patients with Gynecologic Cancer

Abstract

Therapy with rhTPO seems to be safe and may attenuate chemotherapy-induced severe thrombocytopenia and reduce the need for platelet transfusions.

Targeted Approaches for the Treatment of Thrombocytopenia

“…Therapy with rHuTPO is well tolerated, without malaise or fever. Patients treated with this hematopoietic growth factor showed no thrombotic events [54]. Importantly, in contrast to the experience with MGDF, no neutralizing antibodies have been detected in humans receiving rHuTPO.…”

“…The mean platelet count nadir in cycle 2 (carboplatin plus rHuTPO) in this group was higher (44 × 10 9 /l versus 20 × 10 9 /l; p = 0.002) and the number of days with a platelet count <20 × 10 9 /l was shorter (4 versus 7 days; p = 0.006) than in cycle 1 (carboplatin only). In addition, platelet transfusion requirements were reduced from 75% of the patients in cycle 1 to only 25% of patients in cycle 2 (p = 0.013) [54]. Therapy with rHuTPO is well tolerated, without malaise or fever.…”

“…Treatment with Demetri 1.2 µg/kg body weight of rHuTPO, the optimal biologic dose of the c-Mpl ligand, after chemotherapy significantly reduced the degree and duration of thrombocytopenia and enhanced platelet recovery (Table 2) [54]. The mean platelet count nadir in cycle 2 (carboplatin plus rHuTPO) in this group was higher (44 × 10 9 /l versus 20 × 10 9 /l; p = 0.002) and the number of days with a platelet count <20 × 10 9 /l was shorter (4 versus 7 days; p = 0.006) than in cycle 1 (carboplatin only).…”

“…The efficacy and safety of rHuTPO administered before chemotherapy and after a second cycle of chemotherapy was evaluated in a phase I/II study of 29 patients with gynecologic cancer treated with carboplatin [54]. Treatment with Demetri 1.2 µg/kg body weight of rHuTPO, the optimal biologic dose of the c-Mpl ligand, after chemotherapy significantly reduced the degree and duration of thrombocytopenia and enhanced platelet recovery (Table 2) [54].…”

Sequential interleukin 3 and granulocyte‐macrophage–colony stimulating factor therapy in patients with bone marrow failure with long‐term follow‐up of responses

“…Thrombopoietin also may alleviate thrombocytopenia after chemotherapy. 35,36 In the bone marrow failure setting, clinical effects have been both less studied and less pronounced. For instance, a beneficial effect of thrombopoietin in graft failure could not be demonstrated, although this may have been the result of the intermittent dosing schedule used.…”