Oncomedicine 2017; 2:37-41. doi:10.7150/oncm.17909 This volume
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
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. Available from http://www.oncm.org/v02p0037.htm
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