rhIL-11对儿童异基因造血干细胞移植后血小板恢复的影响

The effect of rhIL-11 on the recovery of platelet in children after allogeneic HSCT

目的探讨儿童异基因造血干细胞移植（all-HSCT）后rhIL-11是否具有促进血小板恢复的作用,为临床合理应用rhIL-11提供依据。方法对1998-2006年异基因HSCT患儿的临床资料进行分析。根据疾病种类、植入情况和all-HSCT后rhIL-11是否使用,进行开放、内对照的临床观察。结果A组中,使用者和不使用者平均PLT输注量分别为0.25、0.26 U/d/kg;B组中,使用者和不使用者平均PLT输注量分别为0.24、0.26 U/d/kg;C组中,使用者和不使用者平均PLT输注量分别为0.11、0.12 U/d/kg;尽管使用者平均PLT输注量低于不使用者,但两者间差别无统计学意义（P≥0.05）。同时,三组内使用者和不使用者PLT≥20×10^9/L及PLT≥50×10^9/L时间的差异均无统计学意义。结论本组病例研究显示rhIL-11未能有效促进儿童异基因HSCT后血小板的恢复。

Objective To study the ffect of rhIL-11 on the recovery of platelet in children after allogeneic hematopoietic stem cell transplantation （HSCT）, and show the evidence of how to make good use of rhIL-11 in clinic. Methods The clinical data of pediatric patients, who underwent allogeneic HSCT from the year 1998 to 2006 in the second affiliated hospital of Sun Yat-sen University, were analyzed in a retrospective method. Based on the differences of the diseases, engraftment and the rhIL-11 using or not, the clinical observation was carried out in an open and controlled way. Fifty-one patients were divided into three groups. Group A included 19 patients with β-thalassemia major or severe aplastic anemia and all were engrafted post HSCT, while 9 patients of them were administrated with rhIL-11 and the other 10 were not. Group B included 15 patients with β-thalassemia major or severe aplastic anemia but none of them was engrafted post HSCT, while 6 patients of them were administrated with rhIL-11 and the other 9 were not. Group C included 17 patients with malignant tumors and all were engrafted post HSCT, while 5 patients of them were administrated with rhIL-11 and the other 12 were not. The relationship between the using of rhIL-11 and the doses of platelet transfusions, the platelet recovery were analyzed in each group. Results In group A, the mean doses of platelet transfusions for the patients with rhIL-11 administration and those without were 0.25 U/day/kg and 0.26 U/day/kg, respectively. In group B, the mean doses of platelet transfusions for the patients with rhIL-11 administration and those without were 0.24 U/day/kg and 0.26 U/day/kg, respectively. In group C, the mean doses of platelet transfusions for the patients with rhlL-11 administration and those without were 0.11 U/day/kg and 0.12 U/day/kg, respectively. Although the mean values of platelet transfusions were lower in the patients with rhIL-11 administration than in those without, the differences failed to achieve statistical significance （P≥0.05）. Moreover, no statistically significant differences were found in the mean days of platelet≥ 20×10^9/L or platelet≥50×10^9/L between the patients with rhIL-11 treatment and those without rhIL-11 treatment in each group. Conclusion The drug of rhIL-11 may not promote the recovery of platelet in children after allogeneic HSCT in our retrospective study.