Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment

Dardis, Christopher; Milton, Kelly; Patel, Neel

doi:10.7150/oncm.17909

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Oncomedicine 2017; 2:37-41. doi:10.7150/oncm.17909 This volume Cite

Short Research Communication

Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment

Christopher Dardis^1✉, Kelly Milton¹, Neel Patel²

1. Dept. Neurology, Barrow Neurological Institute, 240 W Thomas Rd, Phoenix, AZ 85013, USA
2. Dept. Family Medicine, Hidalgo Medical Services, 530 De Moss St, Lordsburg, NM 88045, USA

Citation:

Dardis C, Milton K, Patel N. Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment. Oncomedicine 2017; 2:37-41. doi:10.7150/oncm.17909. http://www.oncm.org/v02p0037.htm

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Abstract

Introduction: Chemotherapy-induced thrombocytopenia (CIT) is the principal dose-limiting toxicity in patients with glioma undergoing chemotherapy, affecting up to 25% of such patients.

Methods: This is a retrospective, unblinded case series. Patients undergoing chemotherapy for glioma (astrocytoma, oligodendroglioma or glioblastoma) who developed CIT were prescribed a thrombopoetin receptor agonist (TRA, i.e. eltrombopag or romiplostim). Doses were increased on a weekly basis, as required, until platelets were > 100×10⁹/L or this goal was not achieved with maximum dosing. Chemotherapy was resumed if possible and patients were followed as long as they remained on treatment.

Results: A TRA was effective for CIT in 26/27 (96%). Once treated, all patients were able to resume chemotherapy as planned. Chemotherapy was continued for a median (range) of 11 months (2-28) and patients received an additional 5625 (0-16000) mg/m² of temozolomide, 0 (0-720) mg/m² of lomustine and 75 (0-390) mg/kg of bevacizumab. No patients in this series stopped chemotherapy due to completion of a planned regimen.

Conclusions: By using TRAs for CIT, we were able to continue chemotherapy for a longer time and at higher doses than would have been possible without this treatment. A larger series is necessary in order to determine whether this translates into improved clinical outcomes. CIT is a common problem throughout oncology, and therefore we believe that use of TRA's for this purpose should be further investigated.

Keywords: glioma, thrombopoietin, thrombocytopenia, antineoplastic agents

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APA

Dardis, C., Milton, K., Patel, N. (2017). Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment. Oncomedicine, 2, 37-41. https://doi.org/10.7150/oncm.17909.

ACS

Dardis, C.; Milton, K.; Patel, N. Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment. Oncomedicine 2017, 2, 37-41. DOI: 10.7150/oncm.17909.

NLM

CSE

Dardis C, Milton K, Patel N. 2017. Thrombopoietin Receptor Agonists are Effective in Treating Chemotherapy-induced Thrombocytopenia in Patients with Gliomas Undergoing Myelotoxic Treatment. Oncomedicine. 2:37-41.

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