Systematic review of medication for immune thrombocytopenia after stem cell transplantation
10.13699/j.cnki.1001-6821.2017.04.023
- VernacularTitle:干细胞移植后免疫性血小板减少症药物治疗的系统评价
- Author:
Jing ZHAO
1
;
Chao-Yang CHEN
;
Ying ZHOU
;
Yi-Min CUI
Author Information
1. 北京大学第一医院药剂科
- Keywords:
stem cell transplantation;
immune thrombocytopenia;
systematic review
- From:
The Chinese Journal of Clinical Pharmacology
2017;33(4):372-375
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the effectiveness of medication for immune thrombocytopenia after stem cell transplantation.Methods The literatures about medication of immune thrombocytopenia after stem cell transplantation were selected from the databases of PubMed (1950-2016),COCHARNE LIBRARY CENTRAL(Issue 3th,2012),CBM(1979-2014),CNKI(1976-2014),VIP(1989-2014),according to the inclusion and exclusion criteria.The clinical efficacy and the safety of the medication were evaluated by descriptive analysis.Results A total of 18 reports were enrolled in this study,which included 45 patients,aged from 8 months to 68 years old.There were 13 children and 31 adults,but the age of 1 patient was unknown.A total of 45 patients were conducted a hematopoietic stem cell transplantation,including autologous hematopoietic stem cell transplantation and allogeneic hematopoietic stem cell transplantation.But 0.13 to 68.80 months later,they appeared different degree of refractory immune thrombocytopenia after transplantation.In the treatment of immune thrombocytopenia after transplantation,the drugs IVIG,steroids,rituximab,romiplostim,mesenchymal stem cells (MSC),Vincristine,cyclosporin A,and eltrombopag were effective and the total remission rates were 31.30％ (5/16 cases),21.30％ (5/23 cases),50.00％ (8/16 cases),88.23％ (15/17 cases),100％ (3/3 cases),100％ (1/1 case),0(0/1 case) and 100％ (1/1 case)respectively.Conclusion IVIG and steroids are suggested to be the first-line therapy in the treatment of thrombocytopenia after transplantation.If the outcome of the first-line therapy is not ideal,romiplostim and rituximab are recommended,while MSC therapy,vincristine and eltrombopag would be the last choices.
