Background: Chemotherapy-induced thrombocytopenia (CIT) is a detrimental side effect of cancer chemotherapy. Several pharmacologic agents have been evaluated, but their thrombopoietic activity is modest and often associated with unfavorable side effects. Carica papaya leaf extract (CPLE) is shown to overexpress ALOX-12 and platelet-activating factor receptor gene which stimulates the megakaryopoiesis.
Aims and Objectives: To evaluate the efficacy and safety of CPLE in CIT.
Materials and Methods: A total of 40 patients diagnosed to have CIT were randomized to two groups of 20 subjects each. Interventional group received CPLE 1100 mg TID for 7 days post chemotherapy day 7-14 and non-interventional group did not receive any active treatment. Complete hemogram was done at post chemotherapy day 7, 10, 13, and 16. Patients were followed up for 28 days for adverse effects.
Results: The mean platelet count in interventional group was 49.700 ± 12.649/mm3, which increased to 55.350 ± 15.131/mm3 (P > 0.05), 147.540 ± 54.359/mm3 (P < 0.01), and 200.585 ± 51.893/mm3 (P < 0.01) on post chemotherapy day 7, 10, 13 and 16, respectively. The mean platelet count in non-interventional group was 47.361 ± 13.110/mm3, 42.580 ± 12.108/mm3, 46.367 ± 14.776/mm3, and 54.238 ± 16.053/mm3 on post chemotherapy day 7, 10, 13, and 16, respectively, with no statistically significant improvement (ANOVA, P). Increment in white blood cell from baseline to day 7 was statistically significant (P < 0.001) as compared to control.
Conclusion: CPLE statistically increased platelet count by day 13 of post chemotherapy along with other hematological parameters. Hence, CPLE could be a viable option for treatment of CIT.
Key words: Carica papaya Leaf Extract; Chemotherapy Induced Thrombocytopenia; Platelet Count; White Blood Cell Count