Abstract: Objective  To retrospectively analyze the efficacy and safety of combined hetrombopag in the treatment of cancer therapy induced thrombocytopenia （CTIT） after chemotherapy for germ cell tumors. Methods  The data of patients with CTIT ≥ grade Ⅲ combined with chemotherapy for intracranial germ cell tumors admitted from January 2021 to March 2024 were collected and analyzed, and 33 patients met the enrollment criteria. The patients in the study group were treated with oral hetrombopag combined with subcutaneous injections of recombinant human thrombopoietin (rhTPO) or interleukin-11 (IL-11), and those in the control group were treated with subcutaneous injections of rhTPO or IL-11. The differences of the two groups of patients in platelet counts, platelet-raising response rate, mean onset of action time, and prolongation of the next cycle of treatment before and after the treatment were compared to each other, and the adverse reactions of the two groups were also counted. Results  The platelet counts of patients in both groups were improved post-treatment, with no statistical significance between the two groups for platelet count elevation on days d1, d2, and d3 of the medication (P>0.05). The platelet elevation counts of the study group were significantly elevated on day d(7 ± 3) after the medication compared with the control group, with a statistically significant difference (P<0.05), and the rate of platelet elevation response increased with time prolongation. The mean time to onset of drug administration was 3（3，5） in the study group and 4（3，7）in the control group, with no statistically significant difference (P>0.05). The incidence of prolongation of the time to the next cycle of treatment was 54.5% in the study group and 81.8% in the control group, and the difference between the two groups was not statistically significant (P>0.05). Two patients in the study group developed mild reversible liver function abnormalities. Conclusion  The efficacy of hetrombopag combined with subcutaneous injection of t rhTPO or IL-11 in the treatment of thrombocytopenia after chemotherapy for intracranial germ cell tumors is reliable, and it can significantly elevate platelet counts with tolerable adverse effects.

Key words: hetrombopag, intracranial germ cell tumors, cancer therapy induced thrombocytopenia, recombinant human thrombopoietin, interleukin-11.