骨髓抑制（Myelosuppression）.docVIP

骨髓抑制（Myelosuppression） I. The general regularity and significance of myelosuppression after chemotherapy: At present, the degree of bone marrow suppression after chemotherapy is based on the differentiation criteria of acute and subacute toxicities of WHO anticancer drugs (Table 1). Previous concerns about red cell suppression were less because of the relatively simple treatment of anemia and the rapid availability of transfusions or concentrated red blood cells. But in fact, anemia not only results in hypoxia in the tissues of patients, but also may reduce the effect of radiotherapy or chemotherapy. The absolute value of neutrophils is more important than the total number of leukocytes in the inhibition of granulocyte. Pay attention to two key nodes: first, the absolute value of neutrophils is below 1 * 109/L, and two is less than 50 * 109/L. They are 3 degrees of granulocyte reduction and 3 degree thrombocytopenia, which are critical signs of complications and are indications of intervention. Table 1 grading of bone marrow suppression after chemotherapy Zero One Two Three Four Hemoglobin (g/L) More than 110 109-95 94-80 79-65 65 White blood cell (109/L) More than 4 3.9-3.0 2.9-2.0 1.9-1.0 1.0 Granulocytes (109/L) More than 2 1.9-1.5 1.4-1.0 0.9-0.5 0.5 Platelet (109/L) More than 100 99-75 74-50 49-25 25 It is generally believed that the reduction of granulocytes usually starts at one week after chemotherapy, and reaches the lowest point at 10-14 days after withdrawal. At low levels, the 2~3 slowly rises after U days and returns to normal at 21~28 days. The decrease of platelet was later than that of granulocyte, and it dropped to the minimum at about two weeks. The decrease was rapid, and the retention time was rapid at the bottom of the valley. It was V type. The red blood cell drop occurs later. The pattern of myelosuppression after chemotherapy has the following implications: (1) it limits the duration of chemotherapy. In theory, chemotherapy should be administ