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
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
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