The epidemiology of chemotherapy-induced thrombocytopenia.

摘要

Chemotherapy-induced thrombocytopenia (CIT) is a serious condition that can increase the risk for bleeding and cause chemotherapy dose reductions and delays. Prior research has examined various factors related to CIT, but few addressed the epidemiology of the condition. As a result, there is not enough epidemiologic information to appropriately guide prevention and treatment of CIT. According to diffusion theory, knowledge is the first stage of behavior adoption. Therefore, the purpose of this study was to determine the incidence of CIT, time to CIT across chemotherapy and cancer categories, and to identify high-risk factors associated with developing CIT. A retrospective cohort design was utilized and data for 4,355 eligible patients were obtained from an oncology-specific electronic medical records system. Results of the Cochran-Mantel-Haenszel, log-rank, and stepwise logistic regression analyses indicated that there are differences in the incidence and the time of onset of CIT, and that the relative risk of developing CIT differs for various patient factors. Platinum (31%) and multiple high-risk (13%) chemotherapies had the highest incidence of CIT, in addition to multiple tumors (20%) and lung cancer (19%). Furthermore, low baseline platelet counts (150,000) and platinum/high-risk chemotherapies were the major predictive factors for CIT. Therefore, the primary target groups for prevention and treatment of CIT are patients with low baseline platelet counts and those receiving platinum or multiple high-risk chemotherapies. The findings from this study could ultimately produce positive social change by providing valuable knowledge to physicians in order to more effectively prevent and treat CIT and in turn reduce the negative clinical and economic impacts of this condition on cancer patients and the healthcare system.