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Cancer treatment-induced thrombocytopenia (CTIT) is a common adverse effect in malignant tumor patients, significantly increasing the risk of bleeding and negatively impacting treatment efficacy and quality of life. Current treatment options for CTIT primarily include platelet transfusion, recombinant human interleukin-11 (rhIL-11), recombinant human thrombopoietin (rhTPO) and thrombopoietin receptor agonists (TPO-RAs). However, these methods have their limitations; for instance, platelet transfusions may cause adverse reactions, and the efficacy and safety of rhTPO and TPO-RAs remain controversial. This review aims to summarize the current treatment landscape for CTIT and explore new therapeutic advancement, including the potential role of traditional Chinese medicine, in order to provide more effective treatment strategies for clinical practice.

Objective: Based on real-world research, we aimed to evaluate the effectiveness and economy of recombinant human thrombopoietin (rhTPO) and recombinant human interleukin 11 (rhIL-11) in the treatment of cancer therapy induced thrombocytopenia (CTIT). Methods: We retrospectively collected clinical data of patients with CTIT who were treated with rhTPO or rhIL-11 in a single cancer hospital from January 2020 to December 2021. Propensity score matching (PSM) was applied to eliminate confounding factors. The measurements of effectiveness analysis were the platelet compliance rate, days of medication, days of compliance, highest platelet count after medication, platelet count elevation before and after medication, and the lowest platelet count after next-cycle cancer therapy. The economic evaluation was performed according to the results of the effectiveness evaluation. At the same time, patients were stratified according to type of tumor and grade of thrombocytopenia for subgroup analysis. Results: A total of 262 patients were collected and 174 patients were enrolled after PSM, 87 in the rhTPO group and 87 in the rhIL-11 group. In all patients, there were no significant differences in the platelet compliance rate, mean days of medication, median days of compliance, median highest platelet count after medication, and the median platelet count elevation before and after medication between the two groups ( p > 0.05), but the median lowest platelet count after next-cycle cancer therapy in the rhTPO group was lower than that in the rhIL-11 group ( p = 0.014). The subgroup analysis showed that the rhTPO group had longer mean days of medication than the rhIL-11 group in patients with hematological malignancies ( p = 0.042), and a lower median lowest platelet count after next-cycle cancer therapy in patients with grade I/II thrombocytopenia than rhIL-11 group ( p = 0.022), with no significant difference in other outcome indicators ( p > 0.05). As there was no statistically significant difference in platelet compliance rate between the two groups, the cost-minimization analysis showed that the rhIL-11 group had lower treatment costs than the rhTPO group. Conclusion: RhTPO and rhIL-11 showed similar effectiveness in the treatment of CTIT, but rhIL-11 was more advantageous in economic cost.

Immune checkpoint inhibitors (ICIs) have been widely adopted in the treatment of malignant tumors, and their durable antitumor effects have revolutionized cancer therapy. Immune checkpoint inhibitor‐induced thrombocytopenia (ICIIT) represents a rare but potentially severe or even fatal hematologic toxicity associated with immunotherapy. Therefore, it is imperative for healthcare professionals to recognize this potential adverse event and to understand its identification and management. However, the pathophysiological mechanisms underlying ICIIT remain incompletely understood, and both its diagnosis and treatment pose significant challenges. This review summarizes current knowledge on the epidemiology, prognosis, diagnosis, pathogenesis, and clinical management strategies of ICIIT. The findings of this review may serve as critical evidence to aid clinicians in the recognition and treatment of ICIIT and to inform future research efforts. Subsequent studies should aim to identify predictive biomarkers and develop novel therapeutic approaches to improve patient outcomes.