Management of chemotherapy-induced thrombocytopenia: guidance from the ISTH Subcommittee on Hemostasis and Malignancy Guidelines
| Authors: | Soff, G.; Leader, A.; Al-Samkari, H.; Falanga, A.; Maraveyas, A.; Sanfilippo, K.; Wang, T. F.; Zwicker, J. |
| Title: | Management of chemotherapy-induced thrombocytopenia: guidance from the ISTH Subcommittee on Hemostasis and Malignancy |
| Abstract: | Thrombocytopenia is a common adverse effect of chemotherapy. The development of chemotherapy-induced thrombocytopenia (CIT) is influenced by cancer type and therapy, occurring in approximately one-third of patients with a solid tumor diagnosis and half of all patients with a hematologic malignancy. CIT may complicate the administration of chemotherapy, leading to therapeutic delays or dose reductions. This guidance document, presented by the International Society on Thrombosis and Haemostasis (ISTH) Subcommittee on Hemostasis and Malignancy, provides a comprehensive summary of the evidence and offers direction on the use of thrombopoietin receptor agonists (TPO-RAs) in various settings of CIT, including solid tumors, acute myeloid leukemia, stem cell transplant, and lymphoma. Studies have shown that TPO-RAs can improve platelet counts in CIT, but the clinical benefits of TPO-RA in terms of reducing bleeding, limiting platelet transfusion, avoiding chemotherapy delay, or dose reduction are uncertain. Further research is needed to optimize the selection of appropriate indications and study design to manage thrombocytopenia following chemotherapy. © 2023 International Society on Thrombosis and Haemostasis |
| Keywords: | cancer chemotherapy; unclassified drug; leukemia, myeloid, acute; placebo; drug safety; solid tumor; antineoplastic agents; chemotherapy; antineoplastic agent; bleeding; thrombocytopenia; practice guideline; hematopoietic stem cell transplantation; data base; drug fatality; patient care; disease severity; myelodysplastic syndrome; recombinant fusion proteins; heart infarction; thrombosis; therapy delay; lymphoma; medical society; romiplostim; artery thrombosis; drug induced disease; induction chemotherapy; thrombocyte transfusion; platelet count; hemostasis; thrombopoietin; fusion protein; randomized controlled trial (topic); eltrombopag; complication; hemorrhage; acute myeloid leukemia; tranexamic acid; recombinant thrombopoietin; Common Terminology Criteria for Adverse Events; humans; human; article; chemotherapy induced thrombocytopenia; malignant neoplasm; avatrombopag; thrombopoietin receptor agonist; thrombopoietin receptor agonists; cytokine receptor agonist; lusutrombopag |
| Journal Title: | Journal of Thrombosis and Haemostasis |
| Volume: | 22 |
| Issue: | 1 |
| ISSN: | 1538-7933 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-01-01 |
| Start Page: | 53 |
| End Page: | 60 |
| Language: | English |
| DOI: | 10.1016/j.jtha.2023.09.031 |
| PUBMED: | 37827380 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus |
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