应用rhIL-11治疗急性淋巴细胞白血病化疗相关性血小板减少的疗效观察

Effect of recombinant human interleukin 11 on thrombocytopenia induced by chemotherapy in patient with acute lymphoblastic leukemia

目的观察重组人白介素-11(rhIL-11)对急性淋巴细胞白血病化疗后血小板恢复的影响及其不良反应。方法60例接受化疗的急性淋巴细胞白血病患者随机分为rhIL-11治疗组和对照组。rhIL-11治疗组患者在血小板<60×109/L时给予rhIL-1150μg/kg·d,皮下注射,当血小板≥70×109/L时停药或按药物说明最长用药时间14d;对照组患者仅接受对症支持治疗。期间观察外周血小板计数变化、血小板升至≥70×109/L所需的时间以及药物的毒副反应。结果rhIL-11治疗组患者血小板从最低点恢复至>70×109/L的平均时间为6d,对照组平均为11d,后者较治疗组延长5d(P<0.01)。实验组在治疗过程中10例患者共输注血小板悬液11个治疗量,而对照组有19例输注血小板,共输注血小板悬液25个治疗量,实验组与对照组相比同期血小板输注量明显减少,差异具有统计学意义(P<0.001)。实验组用药前后肝肾功能及凝血功能无明显改变,仅有1例出现感冒样症状,2例出现轻度水肿和血压升高。结论急性淋巴细胞白血病化疗后应用rhIL-11有加速血小板恢复的作用,且该药安全、耐受性好。

Objective To explore the effect of recombinant human interleukin 11（rhIL-11） on thrombocytopenia induced by chemotherapy in patient with acute lymphoblastic leukemia（ALL） and its side-effects.Methods 60 patients with ALL were randomly divided into experimental and control groups.The patients in test group were treated with rhIL-11 since the platelet was under 60× 10^9/L,while the patients in control group were given supporting treatment.Results The average time of the platelet recover to 70×10^9/L was 6 days in experimental group and 11 days in control group（P〈0.01）.Experimental group received 11 times platelet transfusion therapy in the course of treatment,while the control group received 25 times platelet transfusion therapy（P〈0.01）.There were no significant changes in liver function,kidney function and coagulation before and after medication in experimental group,only one case had influenza-like symptoms,2 patients had mild edema and high blood pressure.Conclusion The rhIL-11 is able to accelerate the restoration of the platelets after chemotherapy in patient with acute lymphoblastic leukemia（ALL）,and the drug is safe and well tolerated.