The Study Of Influence About Gemcitabine To The Function Of Platelet And Coagulation

As a new antimetabolic drug,Gemcitabine (GEM) exists a longer time in tumour cells than the old ones,and its better antineoplastic activity in many solid tumours has been confirmed in vitro and in vivo. At the same time , the adverse drug reaction is mild,and can be tolerated.As a result,it is being used more and more widely in treatment of tumour.But thrombocytopenia can be seen in many clinical trials,and limits its use.Despite of thrombocytopenia ,haemorrhagic complication is not common.Study on hemostatic function in thrombocytopenic patients under GEM treatment is rare.Objectives: To observe the changes of hemostatic function of the patients with grade Ⅲ/Ⅳthrombocytopenia after gemcitabine-based chemotherapy.Thereby to help oncologist to adjust the dose intensity of gemcitabine,to obtain maximum clinical efficacy and avoid haemorrhagic complication.Methods: The patients' blood in accord with the selective standard is collected before chemotherapy, and then the platelet aggregation function induced by adenosine diphosphate(ADP),epinephrine(EPN) and collagen (COLL) is measured with the turbidimetry, and the CD62P is measured with the flow cytometry. At the same time the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT) and fibrinogen(FIB) are also measured. The same tests were performed in patients with grade Ⅲ/Ⅳthrombocytopenia after gemcitabine-based chemotherapy. Data were analysed with the paired-samples t testand the paired-samples chi-squre test. Finally the changes of hemostatic function of the patients can be evaluated.Results: The maximum platelet aggregation rates of the patients in accord with the selective standard induced by COLL> EPN and ADP are 59.90± 15.56%> 58.70 + 15.45%> 61.70+16.46% before chemotherapy and 55.25 + 13.58%s 53.65 + 13.34%^ 56.65±15.61% after chemotherapy, respectively. The statistic analytic results with the paired-samples t test and the paired-samples chi-squre test, are not significant(P=0.180s 0.145. 0.164 and 0.404^ 0.368^ 0.368, respectively) between prechemotherapy and postchemotherapy. The CD62P is 7.62 ± 9.95% before chemotherapy and 6.34 + 8.14% after chemotherapy, respectively. The same statistic analytic results can be drawn (P=0.086 and 0.350,respctively).At last the patients' results ofAPTT,PT,TT and FIB are 28.45 + 5.26s> 11.66+2.37s> 14.59 + 2.60s> 4.58 + 1.37g/L before chemotherapy and 30.21+ 5.71s, 11.13 +1.38sx 14.76 + 2.13s, 4.70+ 1.30g/L after chemotherapy, respectively. The same statistic analysis are taken and the results are not significant(P=0.162> 0.339> 0.735> 0.620 and 0.170, 1.000s 0.284 ^ 0.161,respectively).Conclusions: Though the platelet count decreases obviously after gemcitabine-based chemotherapy, the results of this study indicates that function of platelet and coagulation remain unchanged.