rhTPO与IL-11治疗老年白血病化疗后重度血小板减少症的疗效比较

The comparison of curative-effect between rhTPO and IL-11 on severe thrombocytopenia in senile acute leukemia after chemotherapy

目的评估rhTPO(重组人血小板生成素)在老年急性白血病化疗后重度血小板减少症中的疗效。方法选取27例2013年1月-2016年12月于本院治疗的老年急性白血病患者,均为完全缓解患者,接受方案和剂量相同的两周期化疗,第1个周期化疗结束后PLT下降至50×10~9/L以下,予皮下注射rhTPO 15000 u/d,第2周期化疗结束后PLT下降至50×10~9/L以下时予IL-11(白介素-11)1.5 mg/d皮下注射作为对照组,待血小板恢复至50×10~9/L以上时停药,用药时间不超过14天。比较两组患者的血小板恢复情况以及不良反应情况。结果两组患者化疗后的PLT由50×10~9/L降至最小值时间(stage1)、PLT恢复至>20×10~9/L时间(stage2)、PLT恢复至50×10~9/L(stage3)时间三阶段比较均无统计学意义,P>0.05,但此三阶段总时间治疗组与对照组有统计学意义(P=0.0025),对照组不良反应发生率高于治疗组,但两组不良反应比较无统计学意义(P=0.2531)。结论应用重组人血小板生成素治疗老年急性白血病化疗后重度血小板减少症,其疗效及安全性优于白介素-11。

Objective To evaluate the efficacy of recombinant human thrombopoietin（rhTPO） on severe thrombocytopenia after chemotherapy for senile acute leukemia. Methods 27 patients with acute leukemia who were treated in our hospital from January 2013 to December 2016 were selected. The syptoms of all cases were completely relieved and all cases were received the same therapy with two-cycle chemotherapy and same dose. When the PLT decreased to 50×10^9/l after the end of the first cycle, the experimental group were injected subcutaneously rhTPO 15000 u/d. When the PLT decreased to 50×10^9/l after the end of the second cycle, the control group were injected subcutaneously IL-11 1.5 mg/d. When the platelet was restored to 50 ×10^9/L, rhTPO and IL-11 were stopped injection, and the duration of medication should not exceed 14 days. Finally, platelet recovery and adverse reactions were compared between two groups.Results The time when PLT decreased from 50 ×10^9/L to the minimum value（stage1）, the time when PLT was back to 20 ×10^9/L（stage2）and the time when PLT was back to 50×10^9/L（stage3）,had no statistical significance between two groups（P〉0.05）. But the total time at the three stages between treatment group and control group was statistically significant different（P =0.0025）. Incidence of adverse reaction in control group was higher than that in the treatment group, but there was no statistical significance（P =0.2531）.Conclusion Rh TPO was more effective and more safe on treating with severe thrombocytopenia after chemotherapy in senile acute leukemia than IL-11.