rhIL-11防治急性髓细胞白血病强化治疗所致血小板减少症的作用及其机制  

Efficacy of rhlL-11 in management of consolidation chemotherapy-induced thrombocytopenia in acute myeloid leukemia

作　　者：王相华[1] 王欣[1] 李英[1] 张凌岩[1] 徐健[1] 

机构地区：[1]山东省立医院,山东济南250021

出　　处：《山东医药》2007年第17期7-10,共4页Shandong Medical Journal

摘　　要：目的探讨rhIL-11对急性髓细胞白血病（AML）强化治疗所致的血小板（PLT）减少症的作用及其机制。方法38例AML患者每例行两周期强化治疗,化疗方案相同。采用自身对照,对照周期不用rhIL-11,治疗周期化疗后PLT〈50×10^9/L时加用rhIL-11,剂量为25μg/kg（1.5 mg）皮下注射,每日1次,共7~14 d或直至PLT升至50×10^9/L以上。观察rhIL-11的疗效及其副作用。结果32例可供疗效评价。强化治疗后治疗周期最低PLT值高于对照周期（P=0.007）;PLT低位（〈20×10^9/L）持续时间显著短于对照周期（P=0.001）;需输注浓缩PLT例数明显少于对照周期（P=0.039）。化疗后第2周骨髓原始细胞两周期比较无统计学意义（P〉0.05）,但成熟巨核细胞的构成比治疗周期明显高于对照周期（P=0.02）。36例可供安全性评价,rhIL-11相关副作用可耐受。结论rhIL-11可加速AML强化治疗后PLT的恢复,预防严重血小板减少症,减少PLT输注的需求;其机理为刺激骨髓巨核细胞生长、分化和成熟。[Objective]To evaluate the efficacy and safety of rhIL-11 in the management of consolidation chemotherapy-induced thrombocytopenia in acute myeloid leukemia （AML）. [Methods] Thirty eight patients were enrolled in self-control clinical trial ,and each patient received 2 cycles of the same consolidation chemothera- py. Patients only received consolidation chemotherapy in the control cycle,and in the treatment cycle rhlL-11 was given when platelet count ≤ 50× 10^9/L after consolidation chemotherapy,at 25 μg/kg （1.5 mg） ,subcutenously, daily,at least 7 days until the platelet count was higher than 50 × 10^9/L. Observed the efficiency and side effect of thIL-1. [Results] Thirty two of 38 patients were eligible for assessment of efficacy. The minimum platelet count difference compared with in these two cycles had statistical significance （P= 0. 007）. In the treatment cycle,the duration of the platelet count under 20× 10^9/L was shorter than in the control cycle （P=0. 001）, and more patients received platelet transfusion in control cycle compared with treatment cycle （P=0. 039）. In these two cycles there was no significant difference in the ratio of blast cells in bone marrow 2 weeks after consolidation chemotherapy （P〈0.05） ,while the proportion of mature megakaryocytes in treatment cycle was ligher than that in control cycle after consolidation chemotherapy had statistic significance （P= 0. 02）. Thirty six of 38 patients were eligible for assessment of safety. Adverse events associated with rhIL-11 were mild, tolerable. [Conclusions] This study shows rhIL-11 can accelerate the platelet recovery and reduce the need for platelct transfusion after consolidation chemotherapy in AML ,and rhIL-11 plays an important role in the production,diffretention and maturation of megakaryocytes.

关 键 词：RHIL-11 急性髓细胞白血病 缓解后强化治疗 血小板减少症 疗效 副作用 

分 类 号：R558[医药卫生—血液循环系统疾病]