重组人白细胞介素11在自体外周血造血干细胞移植动员中的应用

Recombinant human interleukin-11 used for mobilization in autologous peripheral blood stem-cell transplantation

目的探讨化疗联合重组人白细胞介素11(rhIL-11)和粒细胞集落刺激因子(G-CSF)用于自体外周血造血干细胞移植(APBSCT)动员的可行性和有效性。方法5例恶性血液病患者(估计动员效果差)使用化疗药物24～48h后接受rhIL-11(25μg.kg-1.d-1)和G-CSF(10μg.kg-1.d-1)皮下注射直至干细胞采集结束。观察应用rhIL-11后的动员效果、不良反应及移植后造血重建、并发症和临床转归。结果患者耐受良好,动员后(1.40±0.55)次干细胞采集可获足量CD34+细胞。移植后9～11d内达到造血重建,血小板低于20×109/L时间为0～1d,无出血表现。随访(28.8±8.58)个月,2例分别于移植后8、10个月复发,2例持续完全缓解,1例病情稳定。结论化疗联合rhIL-11和G-CSF方案具有良好的动员效果,且血小板重建迅速。

Objective To explore the feasibility and effectiveness of mobilization with high-dose chemotherapy followed by recombinant human interleuki-11 （rhIL-11） plus granulocyte colony stimulating factor （G-CSF） in autologous peripheral blood stem-cell transplantation （APBSCT）. Methods Five patients with hematological malignancies received high-dose chemotherapy,and 24-48 h after completion of chemotherapy were given daily subcutaneous injections of G-CSF（10μg.kg-^1.d^-1） and rhlL-11（25 μg· kg^-1 · d^-1） until the completion of peripheral stem cell apheresis. The adverse effects of rhlL-11 and the effect of mobilization were observed. Hematopoietic reconstitution, complications and clinical outcome after transplantation were observed as well. Results The use of rhIL-11 was tolerated well by each patient. Adequate number of CD34^＋ cells was obtained after 1.40 ±0.55 apheresis collections in all cases. The time reaching hematopoietic reconstitution was 90 to 11 days. Each patient had a temporary fever during agranulocytosis. The time for platelet count〈20）K 109/L was 0 to 2 days. None of them had bleeding complications. All patients have been followed up for （28.8±8.58） months after transplantation, with complete remission in 2 cases, in steady condition in 1 case, and recurrence in 8 and 10 months later, respectively. Conclusion The regimen of chemotherapy/IL-11 plus G-CSF is successful in mobilizing adequate numbers of CD34^＋ cells,and the reconstruction of platelet is rapid.