重组人白介素-11衍生物对化疗所致血小板减少的疗效和安全性(20例)

目的:观察预防性应用重组人白介素-11(rhIL-11)衍生物治疗化疗所致血小板减少的临床疗效与不良反应。方法:20例恶性肿瘤化疗后出现血小板减少的患者采用自身前后对照研究,对照周期接受化疗后未预防性使用rhIL-11衍生物,试验周期在化疗给药后6～48h内开始预防性应用rhIL-11衍生物,血小板计数300×109/L时停药,或出现血小板下降则使用至血小板计数100×109/L时停药。结果:各例患者使用重组人白介素-11衍生物的实际天数为3～15d,平均为5.2±3.2d,中位天数为4d。试验周期和对照周期血小板计数最低值分别为(57.6±20.6)×109/L和(78.2±29.7)×109/L,血小板减少持续时间分别为8.5±6.3d和5.7±6.3d。与对照周期相比,试验周期(化疗+rhIL-11衍生物)血小板最低值升高(P=0.00)、血小板计数<100×109/L持续时间缩短(P=0.03)。不良反应较轻(以Ⅰ～Ⅱ级为主),停药后能自行缓解,对患者凝血功能无影响。结论:rhIL-11衍生物对恶性肿瘤化疗所致血小板下降有确切的防治作用,且毒副作用耐受可逆、安全性良好。

Efficacy and safety of recombinant human interleukin-11 derivative in the prevention and treatment of chemotherapyinduced thrombocytopenia(20 cases)

Objective:To investigate the clinical efficacy and adverse reaction of recombinant human interleukin-11 derivative in the prevention and treatment of chemotherapy-induced thrombocytopenia in cancer patients.Method:A total of 20 cancer patients with chenmotherapy-induced thrombocytopenia(≤75×109/L)were studied by self-cross control.In the control cycle the patients received chemotherapy,and rhIL-11 derivative was not given for prevention of thrombocytopenia,while in the treatment cycle,rhIL-11 derivative was given(1.5mg/d,subcutaneously)after 6h-48h of chemotherapy infusion until platelet count reached ≥300×109/L.If thrombocytopenia happened,the rhIL-11 derivative was given until platelet count reached ≥100×109/L.Results:The patients were treated with rhIL-11 derivative for actual-day number of 3 to 15 days,with an average of 5.2± 3.2 days,the median-day number of 4 days.The nadir platelet count was 57.6 ±20.6 ×109 / L in the control cycle and 78.2± 29.7×109 / L in the treatment cycle.The days of platelet count less than 100×109/L were 8.5± 6.3 days in the control cycle and 5.7± 6.3 days in the treatment cycle.Compared with the control cycle,treatment cycle(chemotherapy + rhIL-11 derivative) increased nadir platelet levels(p=0.00),and shorten the time of platelet count less than 100×109/L(p=0.03).Adverse reactions were mild(Ⅰ-Ⅱ),mainly included fatigue,musculoskeletal pain,and could relieve itself after stopping rhIL-11 derivative,and there is no effect on the blood coagulation function.Conclusion:rhIL-11 derivative can be effectively used in the prevention and treatment of chemotherapy-induced thrombocytopenia in cancer patients with reversible slight side-effects and good tolerance.