Difference between revisions of "Thrombocytopenia and platelet dysfunction"

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==Definition==
 
==Definition==

Revision as of 13:22, 25 January 2018

Carboplatin & Paclitaxel (CP)

CP: Carboplatin & Paclitaxel

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Forde et al. 2022 (CheckMate 816) 2017-2019 Phase 3 (C) 1a. CP & Nivolumab
1b. CVb & Nivolumab
1c. DC & Nivolumab
Inferior EFS

Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details. This study was conducted in the United States. The reason for the study was that an unanswered question at the time was whether adding an immune checkpoint inhibitor would improve outcomes.

Biomarker eligibility criteria

  • CheckMate 816: No sensitizing EGFR or ALK mutations

Chemotherapy

21-day cycle for 3 cycles

Subsequent treatment

References

  1. CheckMate 816: Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, Kerr K, Wang C, Ciuleanu TE, Saylors GB, Tanaka F, Ito H, Chen KN, Liberman M, Vokes EE, Taube JM, Dorange C, Cai J, Fiore J, Jarkowski A, Balli D, Sausen M, Pandya D, Calvet CY, Girard N; CheckMate 816 Investigators. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022 May 26;386(21):1973-1985. Epub 2022 Apr 11. link to original article contains dosing details in manuscript PubMed NCT02998528

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Definition

Platelet count < 150 × 109/L.

Evaluation

May consist of:

  • CBC with differential
  • Comprehensive metabolic panel, including liver function tests (LFTs)
  • Vitamin B12
  • Folate
  • Assessment for liver disease, hepatomegaly, fatty liver, splenomegaly
  • Peripheral smear, platelet clumps
  • Clinical history (bleeding, temporality, recent infections), TTP/HUS
  • Thrombotic history (e.g. heparin/HIT)
  • Lifestyle factors (e.g. alcohol)
  • Medications
  • Hepatitis serologies
  • HIV
  • ANA, lupus
  • Pseudothrombocytopenia, EDTA-induced clumping (draw sample in blue top citrate tube)
  • Pregnancy/gestational thrombocytopenia
  • ITP