摘要
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.关键词
干细胞移植/免疫性血小板减少症/系统评价Key words
stem cell transplantation/immune thrombocytopenia/systematic review分类
医药卫生
