重组人白细胞介素-11对肿瘤患者化疗后血小板的影响

Effects of recombinant human interleukin-11 on platelet in cancer patients after chemotherapy

目的观察重组人白细胞介素-11(rhIL-11)治疗化疗所致血小板(PLT)减少的疗效和不良反应。方法采用患者自身对照研究,对第1个周期化疗(对照组)后PLT≤70×109/L的42例实体瘤患者,第2个周期(治疗组)采用相同方案化疗,化疗结束后24h开始,皮下注射rhIL-Ⅱ25g/kg,1次/d,连用7～14d,或至PLT≥100×109/L时停药。结果治疗组化疗后各时点PLT计数均高于对照组。化疗后,治疗组和对照组PLT最低值分别为(105.2±51.5)×109/L、(54.6±45.5)×109/L,两组差异有统计学意义(P<0.01)。PLT恢复正常时间,治疗组为2～20d,对照组为5～28d,中位数分别为6、13d,两组差异有统计学意义(P<0.01)。rhIL-Ⅱ的不良反应主要包括:乏力、关节肌肉酸痛、头痛、心悸、水肿和发热等,大多较轻,可以耐受。结论rhIL-11能刺激血小板增生,治疗化疗引起得血小板降低,是一种有效、安全的药物,值得进一步研究。

Objective To investigate the effectiveness and safety of domestically produced recombinant human interleukin 11(rhIL-11)for the treatment of chemotherapy-induced thrombocytopenia.MethodsA total of 42 solid cancer patients who developed chemotherapy-induced thrombocytopenia(≤70 ×109/L)after the first cycle of chemotherapy was studied by self-cross control.The patients were given subcutaneous injection of rhIL-11(25 g/kg·d)for 7 to 14 consecutive days or until platelet count≥100×109/L during the second cycle of chemotherapy using the identical regimen as in the first cycle.Results The mean platelet count of the patients after rhIL-11 treatment was higher at different time points during the second cycle of chemotherapy than that during the first cycle of chemotherapy with the mean platelet count of(105.2±51.5)× 109/L in the first cycle of chemotherapy versus(54.6±45.5)× 109/L in the second cycle of chemotherapy(P<0.01).Patients with platelet count ≤50 ×109/L was 5/42(11.9%)in the first cycle of chemotherapy and 16/42(38.1%)in the second cycle of chemotherapy(P<0.01).The time recovery to the normal platelet count was 2～ 20 days(median 6 days)in the first cycle of chemotherapy versus 5～28 days(median 13 days)in the second cycle of chemotherapy(P<0.01).The major adverse reactions relative to rhIL-11 treatment were fatigue,myalgia/arthralgia,ache,headache,palpitation,edema and fever,most of which could be relieved automatically without any specific treament.Conclusion rhIL-11 is a safe and effective drug for paients with chemotherapy-induced thrombocytopenia via stimulation of the thrombocyte proliferation.