白细胞介素11对恶性血液病患者异基因造血干细胞移植后疗效的影响

Effects of recombinant human interleukin 11 on hematological malignacy after allogeneic hematopoietic cell transplantation

目的 探讨恶性血液病异基因造血干细胞移植（Allo-HSCT）后应用重组白细胞介素（rhIL）11对其疗效的影响.方法 2006年1月至2010年6月中山大学附属中山医院接受Allo-HSCT的48例恶性血液病患者按交替轮转随机选择原则分为用rhIL-11（治疗组）和未用rhIL-11（对照组）两组,各24例,比较两组移植后造血重建、移植物抗宿主病（GVHD）发生率、复发率及生存率.结果 移植后治疗组与对照组中性粒细胞≥0.5 × 109/L和血小板≥20×109/L的时间分别为（15.1±1.6）d比（16.1±1.6）d、（18.2±3.3）d比（22.4±5.5）d,差异均有统计学意义（P=0.032、0.003）;移植后2组100 d内急性GVHD（aGVHD）累积发生率分别为26.1%和50.0%,差异有统计学意义（P=0.048）;2组慢性GVHD（cGVHD）发生率为36.8%和38.9%（P=0.899）,累积复发率为5.1%和7.7%（P=0.662）,3年累积生存率为65.4%和50.9%（P=0.637）,差异均无统计学意义.结论 rhIL-11可促进Allo-HSCT后患者造血重建并降低aGVHD的发生率.

Objective To investigate the effects of recombinant human interleukin 11 （ rhIL-11 ） on hematological malignacy after allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods A total of 48 patients with hematological malignacy from January 2006 to June 2010 were alternately enrolled into a prospective randomized study. And they were assigned into the control and rhIL-11 injection groups.Later the investigators compared two groups with regards to hematopoietic reconstitution, graft versus host disease （GVHD） classification, clinical recurrence rate and disease-free survival. Results With the therapy of rhIL-11, the absolute neutrophil counts recovering to 0. 5 × 109/L and platelet recovering to 20 ×109/L were （ 15. 1 ± 1.6） and （ 18. 2 ±3.3） days respectively. And they were significantly lower than those in control group [（ 16. 1 ± 1.6） vs （22. 4 ± 5.5 ） days, P = 0. 032, 0. 003]. The incidence of acute GVHD was surprisingly low in the study group （ 26. 1% vs 50. 0%, P = 0. 048 ） . There was no significant difference in chronic GVHD （36. 8% vs 38.9%, P =0. 899） or relapse rate （5. 1% vs 7.7%, P =0. 662）between two groups during a median follow-up period of 11.7 months. A trend of improved 3-year-disease-free survival was observed in the study group （ 65. 4% vs 50. 9%, P = 0. 637 ） . Conclusion The application of rhIL-11 after allo-HSCT may accelerate both neutrophil and platelet engraftment and lower the occurrence of acute GVHD.