Clinical Research Of Recombinant Human Interleukin-11Deirvative In The Treatment Of Thrombocytopenia Caused By Chemotherapy In Malignant Tumors

Back ground and purpose: with the developing of oncotherapy, chemotherapy has been more and more important, chemotherapeutics may lead to serious myelosuppression, assume as obvious reduce of blood platelet count、white blood cell count、level of hemoglobin, large sume of reduce of blood platelet can lead to wide rangof bleeding in skin、mucous membrane、 viscera、 intracranial, it’sa threat to life. The reduce of blood platelet can last for a long time, and it is incorrigibility. It limits the action of chemotherapy cyclic, affecting treatment effect. Therefor how to treat thrombocytopenia after cancer chemotherapy become a problem need to be settled.In recent years, a new kind of drug named recombinant human tnterleukin-11(rhIL-11) derivative have been accepted in treatment ofthrombocytopenia after chemotherapy. This paper observes clinical effect of36patients who have suffered by malignant tumor in our division(2010.1-2013.9) and apply recombinant human tnterleukin-11(rhIL-11) derivative to treat thrombocytopenia caused by chemotherapy.Metod: by the method of own contrast, we collected36patients， among them, there are16males and20females. All of themare diagnosed by pathology or cytology as malignant tumor. They are aged from23to77, the mean age is55.53±13.27, PS scores＞ 60, expected lifetime≥3months, The PLT number before chemotherapy≥100×109/L, white blood cell count≥4.0×109/L,HGB≥100g/L. There is no obvious important organ dysfunction ofheart、lung、liver and kidney. There is no hematological system diseases. Chemotherapy regimens are common scheme with platinumcontaining two drugs combination. After the first cycle of chemotherapy, exam blood routine in the nest day and record PLT count ofPB(peripheral blood) as a parameter. When thrombocytopenia to＜75×109/L, give only proper treatment and check blood routineevery other day. When platelet count＜50×109/L, exam blood routine every day. If platelet count＜20×109/L or the bleeding risk is high, inject PLT suspension, until the blood platelet improved to100×109/L, then comes to the second cycle of chemotherapy. The second cycle adopt the same does and methods. Check blood routine and record PLT count of PB as a parameter from the secondday after chemotherapy. The method of recording goes with contrastperiod. When blood platelet count reduces to＜75×109/L, the patients are given rhIL-11derivative by hypodermic injuection at the dose of1.5mg/d for3~14days. When PLT count reduces to＜20×109/L, or the patients are at high risk of bleeding, give a shot of PLT suspension. During the treatment, routine examination of liver function、 renal function、 ion、 blood sugar、 blood clotting function are necessary. Investigate the mean minimum platelet count、howmany days are needed before platelet count begin to bottom out、how much time is needed when platelet go back to normal、the adverse drug reaction and the effect of coagulation function.Result: In the36cases of thrombocytopenia after cancer chem otherapy, the platelet count of treatment group and control group was（120.52±7.39）×109/L、（118.70±8.26）×109/L24h after chemotherapy. The difference was not statistically significant （P＞0.05）.The platelet count of treatment group and control group was（56.06±7.33）×109/L、（37.11±7.55）×109/L1week after chemotherapy.The platelet count of treatment group is much more than the platelet count of control group. The difference was statistically significant（P＜0.05）. The platelet count of treatment group and control group was（153.13±17.87）×109/L、（89.93±15.37）×109/L2weeks after chemotherapy. The difference was statistically significant（P＜0.05）. The mean minimum platelet count of treatment group and control group was （48.08±9.13）×109/L、（33.37±8.57）×109/L, the value of treatment group was much less than the value of control group. The difference was statistically significant（P＜0.05）. Mean days of treatment group and control group of the platelet counts became minimum value were （5.14±1.46）days、（8.94±1.55）days. The difference was statistically significant（P＜0.05）. Mean days of treatment group and control group of the platelet counts higher than100×109/L were （5.89±1.52）days、（9.75±2.26）days. The difference was statistically significant.4cases in control group acceptedinfusion of platelet, No patients in treatment group accepted infusion of platelet. The function of blood coagulation is not obvious affected after recombinant human interleukin-11derivative in the treatment of thrombocytopenia caused by chemotherapy in malignant tumors. Major side effects：injection site hurt、inflammation、sclerosis、edema、conjunctival congestion edema、cardiopalmus and fatigue. M ost of them are not serious and there is no need to special handling. It will alleviate gradually soon after drug withdrawl.Conclusion：After chemotherapy, rhIL-11derivative can shorten the time consumed in thrombocytopenia of patients who sufferedby malignant tumor. Therefore quicken the recover of hemogram, tomake sure chemotherapy are on the rails. It is tolerance and the untoward effects are not serious, worthy of more application and further research.