Thrombocytopenia in cancer patients
Thrombocytopenia in cancer patients
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DOI：
10.1016/s0049-3848(14)50011-4
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发表时间：
2014-05-01
影响因子：
7.5
通讯作者：
Liebman, Howard A.
中科院分区：
文献类型：
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作者：
Liebman, Howard A.
血小板减少症是癌症及其治疗的常见并发症。癌症患者血小板减少的原因可能是多种多样的、多因素的。全身化疗是血小板减少的最常见原因。血小板减少症的程度和持续时间取决于化疗治疗是清髓性（如干细胞移植中使用的）还是非清髓性（通常用于实体非血液恶性肿瘤）。严重血小板减少症的其他原因包括骨髓和脾脏肿瘤受累；微血管病，例如弥散性血管内凝血、血栓性血小板减少性紫癜或溶血性尿毒症综合征。淋巴细胞增殖性恶性肿瘤也可能与继发性免疫性血小板减少症有关。由于与癌症相关血小板减少症相关的广泛鉴别诊断，需要进行仔细的诊断评估。治疗的目标应该是维持安全的血小板计数，以有效治疗潜在的恶性肿瘤，预防出血并发症并尽量减少血小板产品输注的使用。 (C) 2014 Elsevier Ltd. 保留所有权利。
Thrombocytopenia is a frequent complication of cancer and its treatment. The causes of thrombocytopenia in cancer patients can be diverse and multifactorial. Systemic chemotherapy is the most frequent cause of thrombocytopenia. The degree and duration thrombocytopenia depends upon whether the chemotherapeutic treatment is myeloablative, as used in stem cell transplants, or non-myeloablative, as typically used in solid non-hematologic malignancies. Additional causes of significant thrombocytopenia include tumor involvement of bone marrow and spleen; microangiopathic disorders such as disseminated intravascular coagulation, thrombotic thrombocytopenic purpura or hemolytic uremia syndrome. Lymphoproliferative malignancies can also be associated with secondary immune thrombocytopenia. Due to the broad differential diagnosis associated with cancer related thrombocytopenia, a careful diagnostic evaluation is indicated. The goal of treatment should be to maintain a safe platelet count to allow effective treatment of the underlying malignancy, prevent bleeding complications and to minimize the use of platelet product transfusion. (C) 2014 Elsevier Ltd. All rights reserved.