重组人白介素-11对白血病患者造血干细胞移植后血小板的影响

Effect of recombinant human interleukin 11 on the platelet after hematopoietic stem cell transplantation in patients with leukemia

目的:观察重组人白介素-11(rhIL-11,商品名巨和粒)对白血病患者造血干细胞移植后巨核细胞系造血及血小板恢复的影响和不良反应。方法:24例行异基因外周血造血干细胞移植的急、慢性白血病患者随机分为巨和粒治疗组和对照组,治疗组于移植后13d(+13d)起应用巨和粒1.5mg/d,对照组主要采用对症治疗。结果:治疗组血小板计数由最低值恢复至>20×109/L的时间平均为+20.8d,对照组为+26.0d,较治疗组延长5.2d,差异有统计学意义(P<0.01);治疗组血小板计数由最低值恢复至>50×109/L的时间平均为+25.7d,对照组为+32.3d,较治疗组延长6.6d,差异有统计学意义(P<0.01);治疗期间,治疗组平均输注单采血小板2.2次,对照组输注4.1次,较治疗组增加1.9次,差异有统计学意义(P<0.01);+30d,对照组骨髓产板型巨核细胞的数量平均为4.8个,治疗组为12.2个,较对照组增加7.4个,差异有统计学意义(P<0.01)。不良反应以恶心呕吐、乏力、头痛、头晕、注射部位疼痛为主,严重程度均为I^II度。结论:rhIL-11对白血病患者造血干细胞移植后巨核细胞系造血及血小板的恢复疗效确切,不良反应轻微,耐受性好。

Objective To explore the effect and toxicity profile of recombinant human interleukin 11 （ rhIL-11 ） on the platelet after hematopoietic stem cell transplantation in patients with leukemia. Methods Twenty-four patients with acute or chronic leukemia treated by allogeneic peripheral blood stem cell transplantation （PBSCT） were randomly divided into a test group and a control group. The patients in the test group were treated with rhIL-11 since the 13^th day after PBSCT （1.5 mg/d）, while the control group were given symptomatic treatment. Results The average time for the platelet to recover to the level of 20 × 10^9/L was 20. 8 days in the test group, and 26.0 days in control group respectively, there was significant difference （ P 〈 0.01 ）. The average time for the platelet to recover to the level of 50 × 10^9/L was 25.7 days in the test group, and 32.3 days in the control group respectively, there was also significant difference （ P 〈 0.01 ）. The average time for the platelet transfusion was 2.2 in the test group, 4. 1 in the control group, and there was signif-icantly different （ P 〈0. 01 ）. The average number of megakaryocytes was 12.2 in the test group,4.8 in the control group on 30＇h day after the transplantation, and there was significant difference （ P 〈0. 01 ）. The main side effects of rhIL-11 were nausea, vomit, debility, headache, dizzy and pain ofinjection site, and the degree was all Ⅰ～Ⅱ grade. Conclusion rhIL-11 has definite recuperativeeffect on the recovery of the platelet after PBSCT. There is little side effect, and it can be accepted.