A prospective study of the early treatment of recombinant human thrombopoietin for chemoradiation-induced thrombocytopenia in cervical squamous cell carcinoma patients.

12125 Background: To explore the early intervention timing of recombinant human thrombopoietin (rhTPO) for cancer treatment-induced thrombocytopenia (CTIT) in cervical squamous cell carcinoma (CSCC) patients during concurrent chemoradiotherapy. Methods: Patients with stage I-IVa CSCC who developed CTIT during radical concurrent chemoradiotherapy were prospectively enrolled in our study. rhTPO intervention was used at the first presentation of G1 or G2 CTIT during concurrent chemotherapy respectively. The key indexes, including nadir platelet count, platelet recovery time, platelet transfusion and incidence of G3-5 CTIT were recorded in two groups. χ² test was used for the effective analysis, and univariate and multivariate analyses logistic regression analysis was used to predict the potential factors for the G3-5 CTIT. Results: From February 2021 to June 2024, 204 CSCC patients who developed CTIT during radical chemoradiotherapy at Sichuan Cancer Hospital were prospectively enrolled. 75 patients who occurred G1 and G2 CTIT at the first presentation during concurrent chemoradiotherapy received rhTPO intervention. They were included in the intent-to-treat (ITT) population analysis. According to the timing of the rhTPO intervention, the patients were divided into G1 group (100×10 9 /L>PLT>75×10 9 /L) and G2 group (75×10 9 /L>PLT>50×10 9 /L). For effective analysis, the nadir platelet count in G1 group was greater than that in G2 group (67 × 10 9 /L vs. 54 × 10 9 /L, p = 0.000), and the platelet recovery time in G1 group was shorter than that in G2 group (8 days vs. 14 days, p = 0.003). Moreover, patients in G1 group had a significantly lower incidence of G3-5 CTIT than that in G2 group (14.3% vs. 35%, p = 0.04). In two groups, only 1 patient in G2 group received 4 apheresis platelet units transfusion. Univariate and multivariate analysis showed the early intervention of the rhTPO was a substantial factor for decreasing the incidence of G3-5 CTIT. The sensitivity was 0.67 and the specificity was 0.74. Conclusions: For CSCC patients received with radical concurrent chemoradiotherapy, the early intervention of rhTPO was a substantial factor for decreasing the incidence of G3-5 CTIT. It could significantly improve the nadir platelet count, shorten the platelet recovery time, and reduce the incidence of G3-5 CTIT, thereby ensuring the uninterrupted continuation of treatment. Platelet recovery time and the degree of CTIT. Data Baseline platelet count(×10 9 /L) Days with platelet count recover ≥100×10 9 (Days) Minimal mean platelet count（×10 9 /L） Incidence of G3-5 CTIT(%) G1 group 172±64.92 8±5.86 67±15.81 14.3 G2 group 166±78.43 14±9.59 54±14.37 35 P value 0.76 0.003* 0.000* 0.04* *Statistically significant.