重组人白细胞介素-11治疗急性髓系白血病化疗后血小板减少效果观察

Effect of recombinant human interleukin-11 on chemotherapy-induced thrombocytopenia in patients with acute myeloid leukemia

目的观察重组人白细胞介素-11(recombinant human interleukin-11,rhIL-11)治疗急性髓系白血病患者化疗后血小板减少的效果及不良反应。方法 36例急性髓系白血病患者随机分为观察组和对照组各18例,2组化疗均采用DA(柔红霉素+阿糖胞苷)或MA(米托蒽醌+阿糖胞苷)方案。化疗期间出现血小板计数<20×109/L或≥20×109/L但有出血倾向时,对照组静脉滴注血小板;观察组血小板用法、用量同对照组,并于化疗结束后注射rhIL-11 1.5mg/次,1次/d,至血小板计数恢复至100×109/L以上停用。观察2组血小板计数最低值及恢复至100×109/L时间、化疗期间出血情况及血小板输注量以及2组化疗结束后第14天骨髓巨核细胞数量。结果观察组血小板计数最低值、化疗结束后第14天骨髓巨核细胞数量高于对照组(P<0.05),血小板计数恢复至100×109/L时间、血小板输注量、出血发生率低于对照组(P<0.05)。结论 rhIL-11用于治疗急性髓系白血病化疗后血小板减少,可缩短血小板恢复时间,不良反应轻。

Objective To explore the effect and adverse reactions of recombinant human interleukin-11（rhIL-11） in the treatment of chemotherapy-induced thrombocytopenia in patients with acute myeloid leukemia （AML）. Methods Thirty-six AML patients were randomly divided into observation group and control group, with 18 patients in each group. Both two groups received DA or MA scheme chemotherapy. Control group was intravenously injected platelet when platelet count was lower than 20×10^9/L, or the patients had hemorrhagic tendency although the platelet count was 20×10^9/L or higher. Observation group was injected rhIL-11 （1.5 mg/d） until platelet count was higher than 100×10^9/L in addition to the routine therapy in control group. The nadir platelet count, recovery time of platelet count to 100×10^9/L, hemorrhage, platelet transfusion and megakaryocytes in bone marrow by day 14 after chemotherapy were observed and compared between two groups. Results The nadir platelet count and megakaryocytes in bone marrow were higher in observation group than those in control group （P〈0.05）. The recovery time of platelet count to 100 ×10^9/L was shorter, and platelet transfusion and incidence of hemorrhage were lower in observation group compared with control group （P〈0.05）. Conclusions rhlL-11 can shorten the recovery time of platelet in the treatment of chemotherapyinduced thrombocytopenia in AML patients and the adverse reaction is mild.