Clinical Observation Of Recombinant Human Interleukin-11Deirvative In The Treatment Of Thormbocytopenia Caused By Chemothearpy In Malignant Tumors

Backgrand and Objective: Bone marrow depression is the mostcommon and the most severe toxicity in patients with malignant tumor afterchemotherapy. Peripheral blood leukocytes, platelets decreased obviouslylimiting the chemotherapy process, cause direct adverse effect about prognosis.Currently thrombocytopenia induced by chemotherapy is now a gravenessproblem which we face with clinically. In recent years, along with hematop-oietic growth factors in development and research, which gives patients newwish. Recombinant human interleukin11(rhIL-11) derivative as a kind of drug,after I～III clinical trials, which have confirmed the safety and efficacy, hasgetting into the Ⅳ clinical trial, this paper study on malignant tumorchemotherapy induced thrombocytopenia in the clinical efficacy of thetreatment, on coagulation function effects and adverse reactions. This textobserves therapeutic effect for the patients with thrombocytopenia caused bychemotherapy and effect of blood coagulation function and side effect.Method: The test adopted own contrast, collecting21patients who hadbeen diagnosed by pathology and cytology as malignant tumor, of which themale number is9and the female number is12.The mean age is57.4years old.All patients PS scores>60, the expected lifetime≥3months, WBC of allpatients before chemotherapy≥4.0×10~9/L, HGB≥100g/L, PLT≥100×10~9/L,Chemotherapy regimens are platinum containing two drugs combined withinternational common scheme according to the standard dose, First cycles ofthrombocytopenia after chemotherapy to <75×10~9/L, gives only symptomatic and supportive therapy, until the blood platelet improved naturally to100×10~9/L or above, as their own controls cycle, the second cycle used the samemethods and dose to cure, when blood platelet count is reviewed reduced to75×10~9/L or lower after the second cycle of chemotherapy was finished, thepatients are given recombinant human interleukin-11derivative at the dose of1.5mg/d subcutaneously for3to14days.We review the blood every other day.When PLT count <50×10~9/L, every day after the blood routine examination. Ifplatelet count <20×10~9/L,or platelet count is>20×10~9/L, but the bleeding riskis high, can be transfused platelet suspension. Discontinue the drug whenplatelet count is found received to100×10~9/L or high, more than14days ofplatelet count <100×10~9/L also stop. Investigate the mean minimum plateletcount, the mean platelet count2weeks after chemotherapy and the effect ofcoagulation function between treatment group and control group. Evaluationcriterion of adverse reaction according to WHO anticancer drugs in acute andsubacute toxicity standard. Statistical treatment is completed with SPSS18.0package. Measurement data is expressed by mean(X)±standard deviation(s),Count data is using linear related and regression analysis and T test, P<0.05isconsidered as statistical significance.Result: In the control cycle (the first cycle): the mean minimum plateletcount was （35.95±13.33）×10~9/L. The mean paletlet count2weeks afterchemotherapy was（79.67±23.87）×10~9/L, Mean days of the platelet countslower than100×10~9/L were9.48±2.84days. Total2cases accepted infusion ofplatelet. Study cycle (the second cycle): The mean minimum platelet count was（52.14±11.53）×10~9/L (P<0.05). The mean paletlet count2weeks afterchemotherapy was （153.86±60.10）×10~9/L， Mean days of the platelet countslower than100×10~9/L were5.43±1.78days (P<0.05).Compared with controlgroup,4days were saved. The difference was statistically significant. Nopatients accepted infusion of platelet. Major side effects：edema, fatigue, arthralgia, muscle pain, dizziness and headache, conjunctival congestion,cardiopalmus, fever, All the reactions were I～II degrees, need no specialhandling and alleviates gradually. after drug withdrawl.Conclusion: Recombinant human interleukin-11derivative can stimulateplatelet hyperplasia and elevate blood platelet count obviously, prevent thereduction of blood platelet and shorten the duration of thrombocytopeniainduced by chemotherapy, to recover the hemogram quickly, to ensure nextchemotherapy in time and sufficiently, rhIL-11derivative for the treatment ofchemotherapy-induced thrombocytopenia has no obvious effect on coagulationmechanism. No significant effects on blood coagulation function. Its sideeffects were tolerable and it may be a safe and effective drug for treatment ofthrombocytopenia, worthy of further research and application.