重组人白细胞介素-11治疗化疗后血小板减少疗效观察

Effectiveness of rhIL-11 for treatment of thrombocytopenia following chemotherapy

目的:观察重组人白细胞介素11(rhIL11)治疗实体瘤和急性白血病(AL)患者化疗后血小板减少的疗效及安全性。方法:实体瘤患者25例、AL患者20例,于化疗结束后BPC≤30×109/L时予rhIL1150μg/(kg·d)皮下注射,连用7～14天或BPC升高至≥60×109/L时停药,用药期间隔天查血常规1次,观察外周血BPC变化、皮肤出血情况及rhIL11应用的不良反应。以同期未用rhIL11治疗的15例实体瘤和10例AL患者作对照。结果:治疗组用药后1周和2周,BPC在实体瘤患者分别为(67.68±9.3)×109/L、(86.55±12.76)×109/L;在AL患者分别为(69.83±7.68)×109/L、(87.17±8.66)×109/L。治疗组较对照组BPC恢复时间缩短(P<0.05)。常见不良反应为轻度乏力、肌肉疼痛。3例出现短暂房性心律失常,减量或停药后消失。结论:rhIL11治疗实体瘤和AL患者化疗后引起的血小板减少安全有效,可使BPC恢复加快,并有效缓解出血症状。

Objective Observation on effectiveness and safety of rbIL- 11 for treatment of thrombocytopenia following chemotheraphy. Methods： 70 patients whose BPC were less than 30×10^9/L. after chemotherapy were enrolled in the study. 40 patients were consulting solid tumor（ST）and 30 patients were consulting acute leukemia（AL）. The participating patients were randomly allocated to treatment group（ST：25, AL：20）and control group（ST： 15,AL：10）. The treatment group was injected subcutaneous with a 50 μg/kg dose of rhIL-11 daily for a period of 7 to 14 days,or until the BPC exceeded 60 × 10^9 /L. Main outcome measures： Changes of thrombocyte concent ration in peripheral blood, dermatorrhagia, and side effects of rhIL-11 treatment. Results：BPC measurement one week and two weeks after start of treatment, The treatment group after one week：（67.68 ± 9.30） ×10^9/L.（ST） and（69.83±7.68） ）×10^9/L.（AL） The treatment group after two weeks：（86. 55±12.76） ×10^9/L（ST）and（87. 17 ±8. 66） ×10^9/L.（AL）. The control group after one week： （44.63±9.03） × 10^9/L.（ST）and（44.00±8. 42） ×10^9/L.（AL）The control group after two weeks： （66.08±6.44） ×10^9/L.（ST）and（64.63±4.41） ×10^9/L （AL）. When comparing the two groups the BPC increases more rapidly for the treatment group than for the control group. The frequent side effect of rhll. 11 treatment are hypodynamia and muscle pain. 3 patients with transient atrial arrhythmia were observed but the symptom disappeared when medication was terminated or the doses reduced. Conclusions： rhIL-11 is an effective and safe treatment of thrombocytopenia after chemotherapy. The drug can increase the rate of thrombocyte production. The duration of thrombocytopenia and dermatorrhagia is reduced.