Recombinant human thrombopoietin attenuates carboplatin-induced severe thrombocytopenia and the need for platelet transfusions in patients with gynecologic cancer.
BACKGROUND
Thrombocytopenia is a significant problem in the treatment of cancer.


OBJECTIVE
To assess the clinical safety of therapy with recombinant human thrombopoietin (rhTPO) and its ability to ameliorate chemotherapy-induced severe thrombocytopenia.


METHODS
Phase I/II clinical cohort study.


METHODS
The University of Texas M.D. Anderson Cancer Center, Houston, Texas.


METHODS
29 patients with gynecologic cancer.


METHODS
Recombinant human thrombopoietin was given before chemotherapy and after a second cycle of carboplatin therapy.


METHODS
Peripheral blood counts and platelet transfusions.


RESULTS
Administration of rhTPO after chemotherapy significantly reduced the degree and duration of thrombocytopenia and enhanced platelet recovery. In patients who received the optimal biological dose of rhTPO (1.2 microg/kg of body weight) in cycle 2 (carboplatin plus rhTPO), the mean platelet count nadir was higher (44x10(9) cells/L and 20x10(9) cells/L; P = 0.002) and the duration of thrombocytopenia was shorter (days with a platelet count <20x10(9) cells/L, 1 and 4 [P = 0.002]; days with a platelet count <50x10(9) cells/L, 4 and 7 [P = 0.006]) than in cycle 1 (carboplatin only). The need for platelet transfusion in this group was reduced from 75% of patients in cycle 1 to 25% of patients in cycle 2 (P = 0.013).


CONCLUSIONS
Therapy with rhTPO seems to be safe and may attenuate chemotherapy-induced severe thrombocytopenia and reduce the need for platelet transfusions.
Vadhan-Raj
S
S
Department of Bioimmunotherapy, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. svadhanr@notes.mdacc.tmc.edu
Verschraegen
C F
CF
Bueso-Ramos
C
C
Broxmeyer
H E
HE
Kudelkà
A P
AP
Freedman
R S
RS
Edwards
C L
CL
Gershenson
D
D
Jones
D
D
Ashby
M
M
Kavanagh
J J
JJ
D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D010976:Platelet Count; D017713:Platelet Transfusion; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000517:prevention & control* / Q000628:therapy; D013926:Thrombopoietin / Q000008:administration & dosage / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D013926:Thrombopoietin; D016190:Carboplatin