A real‐world observation on thrombopoietic agents for patients with cancer treatment–induced thrombocytopenia in China: A multicenter, cross‐sectional study

Article

Author: Wang, Huaqing ; Ba, Yi ; Qian, Liting ; Yuan, Xianglin ; Wang, Wei ; Zhang, Yanqiao ; Shu, Yongqian ; Xue, Cong ; Zhou, Min ; Liu, Tianshu ; Li, Xiaoling ; Cheng, Jing ; Liao, Zijun ; Gu, Kangsheng ; Zhang, Qingyuan ; Wang, Chang ; Hou, Mei ; Qiu, Wensheng ; Chen, Xi ; Zhong, Jincai ; Xu, Ruilian ; Feng, Jifeng ; Yang, Runxiang ; Zhang, Mingzhi ; Xia, Qing ; Li, Enxiao ; Liao, Wangjun ; Chen, Xiaobing ; Chen, Meiting ; Wang, Xiaojia ; An, Xin ; Chen, Yu ; Li, Lu ; Shen, Bo ; Ma, Fei ; Yang, Nong ; Deng, Ting ; Wang, Zhehai ; Liu, Bin ; Shi, Yanxia

AbstractBackgroundStudies on various thrombopoietic agents for cancer treatment–induced thrombocytopenia (CTIT) in China are lacking. This study aimed to provide detailed clinical profiles to understand the outcomes and safety of different CTIT treatment regimens.MethodsIn this retrospective, cross‐sectional study, 1664 questionnaires were collected from 33 hospitals between March 1 and July 1, 2021. Patients aged >18 years were enrolled who were diagnosed with CTIT and treated with recombinant interleukin 11 (rhIL‐11), recombinant thrombopoietin (rhTPO), or a thrombopoietin receptor agonist (TPO‐RA). The outcomes, compliance, and safety of different treatments were analyzed.ResultsAmong the 1437 analyzable cases, most patients were treated with either rhTPO alone (49.3%) or rhIL‐11 alone (27.0%). The most common combination regimen used was rhTPO and rhIL‐11 (10.9%). Platelet transfusions were received by 117 cases (8.1%). In multivariate analysis, rhTPO was associated with a significantly lower proportion of platelet recovery, platelet transfusion, and hospitalization due to chemotherapy‐induced thrombocytopenia (CIT) than rhIL‐11 alone. No significant difference was observed in the time taken to achieve a platelet count of >100 × 109/L and chemotherapy dose reduction due to CIT among the different thrombopoietic agents. The outcomes of thrombocytopenia in 170 patients who received targeted therapy and/or immunotherapy are also summarized. The results show that the proportion of platelet recovery was similar among the different thrombopoietic agents. No new safety signals related to thrombopoietic agents were observed in this study. A higher proportion of physicians preferred to continue treatment with TPO‐RA alone than with rhTPO and rhIL‐11.ConclusionsThis survey provides an overview of CTIT and the application of various thrombopoietic agents throughout China. Comparison of monotherapy with rhIL‐11, rhTPO, and TPO‐RA requires further randomized clinical trials. The appropriate application for thrombopoietic agents should depend on the pretreatment of platelets, treatment variables, and risk of bleeding.Plain Language Summary

To provide an overview of the outcome of cancer treatment–induced thrombocytopenia in China, our cross‐sectional study analyzed 1437 cases treated with different thrombopoietic agents.

Most of the patients were treated with recombinant interleukin 11 (rhIL‐11) and recombinant thrombopoietin (rhTPO).

rhTPO was associated with a significantly lower proportion of platelet recovery and platelet transfusion compared with rhIL‐11.

05 Sep 2023·Zhonghua yi xue za zhi

[Consensus on the clinical diagnosis, treatment and prevention of cancer treatment-induced thrombocytopenia in China (2023 edition)].

Review

Cancer treatment-induced thrombocytopenia (CTIT) is a common adverse event during anti-tumor treatment, of which incidence is related to tumor classification, regimens, course of chemotherapy, etc. CTIT may result in a series of events including bleeding, dose intensity reduction, chemotherapy delay, and in severe cases, even the need for platelet transfusion, ultimately affecting the implementation of treatment plan, increasing the cost of treatment, reducing treatment effect and quality of life, and leading to a poor prognosis. The treatment of CTIT should first identify the cause, assess the risk of bleeding, and then adopt treatment strategies according to the cause and severity of CTIT. The main treatments of CTIT include platelet transfusion, application of various types of platelet-producing drugs, and measures to reduce the additional loss of platelets. Among them, platelet-producing drugs mainly refer to platelet-stimulating factors, including recombinant human thrombopoietin (rhTPO), recombinant human interleukin 11(rhIL-11), and thrombopoietin receptor agonists (TPO-RAs). In addition, traditional Chinese medicine also has some assistance in raising platelets. Pharmacological prophylaxis in high-risk patients may help reduce the incidence and severity of CTIT. This consensus aims to support Chinese oncologists in the diagnosis and treatment of CTIT in China, reduce the risk of bleeding and improve the quality of life of patients.

12 Jul 2023·BMC oral health

Efficacy of recombinant human interleukin-11 in preventing and treating oral mucositis after chemotherapy for patients with acute leukemia.

Article

Author: Zhao, Wei ; Zhang, Lin ; Li, Yuxin ; Huang, Zhuan ; Zhang, Pengyu ; He, Aili ; Wang, Jin ; Lei, Bo ; Zhang, Yilin ; Ma, Xiaorong

OBJECTIVEThis study aimed to investigate the clinical effects of recombinant human interleukin-11 (rhIL-11) gargle on preventing and treating oral mucositis (OM) after chemotherapy for acute leukemia.METHODSThis single-site, prospective, observer-blinded, nonrandomized controlled trial was conducted on 74 patients with acute leukemia, who were divided into the experimental and control groups. The patients in the experimental group were treated with IL-11 gargle, and those in the control group were treated with sodium bicarbonate gargle. We examined the time and severity of oral mucositis, severity and duration of associated pain, healing time of mucositis, effects of OM on eating, and levels of T-cell subset indicators before and after treatment to evaluate the effects of IL-11 treatment.RESULTSThe proportion of patients with severe OM was significantly lower in the experimental group than in the control group. Mucositis occurred later in the experimental group compared with the control group. The degree and duration of pain, ulcer healing time, and effects on eating were lower in the experimental group compared with the control group. Following treatment, the levels of all T-cell subset indicators improved in each of the two groups. However, the rate of improvement was significantly higher in the experimental group than in the control group. These differences were statistically significant (P < 0.05).CONCLUSIONSIL-11 gargle reduced the severity of OM after chemotherapy for acute leukemia. Treatment with IL-11 relieved pain, promoted healing, and improved the curative effect of the condition, making it worthy of clinical promotion.

100 Deals associated with Recombinant human interleukin-11(Qilu Pharmaceutical Co., Ltd.)

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Indication	Country/Location	Organization	Date
Thrombocytopenia	CN	Qilu Pharmaceutical Co., Ltd.	18 Mar 2003

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