目的 探讨恶性血液病异基因造血干细胞移植(Allo-HSCT)后应用重组白细胞介素(rhIL)11对其疗效的影响.方法 2006年1月至2010年6月中山大学附属中山医院接受Allo-HSCT的48例恶性血液病患者按交替轮转随机选择原则分为用rhIL-11(治疗组)和未用rhIL-11(对照组)两组,各24例,比较两组移植后造血重建、移植物抗宿主病(GVHD)发生率、复发率及生存率.结果 移植后治疗组与对照组中性粒细胞≥0.5 × 109/L和血小板≥20×109/L的时间分别为(15.1±1.6)d比(16.1±1.6)d、(18.2±3.3)d比(22.4±5.5)d,差异均有统计学意义(P=0.032、0.003);移植后2组100 d内急性GVHD(aGVHD)累积发生率分别为26.1%和50.0%,差异有统计学意义(P=0.048);2组慢性GVHD(cGVHD)发生率为36.8%和38.9%(P=0.899),累积复发率为5.1%和7.7%(P=0.662),3年累积生存率为65.4%和50.9%(P=0.637),差异均无统计学意义.结论 rhIL-11可促进Allo-HSCT后患者造血重建并降低aGVHD的发生率.
Objective To investigate the effects of recombinant human interleukin 11 ( rhIL-11 ) on hematological malignacy after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods A total of 48 patients with hematological malignacy from January 2006 to June 2010 were alternately enrolled into a prospective randomized study. And they were assigned into the control and rhIL-11 injection groups.Later the investigators compared two groups with regards to hematopoietic reconstitution, graft versus host disease (GVHD) classification, clinical recurrence rate and disease-free survival. Results With the therapy of rhIL-11, the absolute neutrophil counts recovering to 0. 5 × 109/L and platelet recovering to 20 ×109/L were ( 15. 1 ± 1.6) and ( 18. 2 ±3.3) days respectively. And they were significantly lower than those in control group [( 16. 1 ± 1.6) vs (22. 4 ± 5.5 ) days, P = 0. 032, 0. 003]. The incidence of acute GVHD was surprisingly low in the study group ( 26. 1% vs 50. 0%, P = 0. 048 ) . There was no significant difference in chronic GVHD (36. 8% vs 38.9%, P =0. 899) or relapse rate (5. 1% vs 7.7%, P =0. 662)between two groups during a median follow-up period of 11.7 months. A trend of improved 3-year-disease-free survival was observed in the study group ( 65. 4% vs 50. 9%, P = 0. 637 ) . Conclusion The application of rhIL-11 after allo-HSCT may accelerate both neutrophil and platelet engraftment and lower the occurrence of acute GVHD.