rhIL-11对儿童急性淋巴细胞性白血病化疗后血小板减少疗效

THE EFFECT OF rhIL-11 ON CHEMOTHERAPY-INDUCED THROMBOCYTOPENIA IN CHILDREN WITH ACUTE LYMPHOCYTIC LEUKEMIA

目的观察重组人白细胞介素-11（rhIL-11）对儿童急性淋巴细胞性白血病（ALL）化疗所致血小板减少的临床疗效。方法以青岛市儿童医院、青岛大学医学院附属医院2007--2008年新发ALL共31例为实验组，于CAT巩固化疗结束后24h测血小板，当其≤50×10^9／L时，给予50μg／kg或1．5mg／d皮下注射rhIL-11，连续应用7～14d或应用至血小板达到正常水平。以青岛大学医学院附属医院2000-2001年新发ALL病儿33例为对照组（两组化疗方案相同）。对照组于巩固化疗结束后不给予rhIL-11皮下注射治疗。结果化疗结束后两组血小板数量比较无明显差异，用药后7、14d比较，两组血小板数量差异均有显著性（r=3．275、3．198，P〈0．01）。治疗组血小板恢复正常时间明显短于对照组（r=2．425，P〈0．05）。应用rhIL-11后，仅1例出现下肢关节疼痛、乏力，4例出现注射部位疼痛，1例出现头晕，停药后症状缓解。结论rhIL-11可明显升高儿童ALL化疗后血小板数量，减少血小板下降的时间，且不良反应少。

Objective To investigate the efficacy of recombinant human interleukin-11 （rhlL-11） in the treatment of chemotherapy-induced thrombocytopenia in children acute lymphocytic leukemia （ALL）. Methods Thirty-one newly diagnosed ALL patients in 2007--2008 at Qingdao Children Hospital and the Affiliated Hospital of Qingdao University Medical College were enrolled in this study. Intra-hypodermic （ih） injection of 50 μg/kg or 1.5 mg/d of rhlL-11 was given to patients when their platelet count was lower than 50× 10^9/L after CAT consolidation chemotherapy. The rhIL-11 treatment either lasted for 7-14 days or continued until platelet count was normal. Thirty-three new ALL patients between year 2000 and 2001 confirmed at the Affiliated Hospital were served as control group, in which the same above therapy was given except rhIL-11 after CAT consolidation chemotherapy. Results Upon completion of the therapy, the platelet count between the two groups was not significantly different, but the difference was obvious after 7 and 14 days after rhIL-11 treatment （t=3. 275,3. 198;P〈0.01）. The recovery time of platelet count was significantly shorter in the study group than that in the control （t = 2. 425, P〈0.05）. After application of rhIL-11, only one patient had joint pain of lower extremity and fatigue, four had pain on injection site, and one with dizziness. All the symptoms relieved after discontinuation of rhIL-11. Conclusion Administration of rhIL-11 can significantly increase platelet count in children with acute lymphocytic leukemia after chemotherapy and shorten the time for platelet returning to normal level with few side effects.