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诊断时的血小板和外周血白细胞计数可预测成人免疫性血小板减少症对重组人白细胞介素-11的反应:一项回顾性、单中心、病例对照研究。

Platelet and peripheral white blood cell counts at diagnosis predict the response of adult immune thrombocytopenia to recombinant human interleukin-11: A retrospective, single-center, case-control study.

作者信息

Jin Chenghao, Wang Yulu, Cheng Hongbo, Liu Haiyun, Liu Tingting, Ke Bo, Li Anna, Yang Liu, Zhu Qingxiu, Ding Weirong, Luo Minzhi, Wei Yujing, Kong Chunfang

机构信息

Department of Hematology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University.

Key Biologic Laboratory of Blood Tumor Cell of Jiangxi Province.

出版信息

Medicine (Baltimore). 2019 Apr;98(16):e15195. doi: 10.1097/MD.0000000000015195.

DOI:10.1097/MD.0000000000015195
PMID:31008943
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6494275/
Abstract

This study evaluated the effectiveness of recombinant human interleukin-11 (rhIL-11) in the treatment of immune thrombocytopenia (ITP) and determined whether clinical and laboratory findings predicted the treatment response.This retrospective, single-center, case-control study included 103 adult patients with ITP treated between July 2010 and April 2014 at Jiangxi Province People's Hospital. About 49 patients in the pred+IL group received prednisone (conventional dose) combined with an rhIL-11 regimen, and 54 patients in the pred alone group received prednisone (conventional dose) alone. Demographic data, initial and follow-up platelet counts, proportions of patients achieving platelet counts ≥30 × 10/L (response) and ≥100 × 10/L (complete response) at different time points, and adverse reactions were compared between groups.Complete response rates were similar between groups overall but higher in the pred+IL group than in the pred alone group for newly diagnosed patients and those with severe ITP (P < .05). Proportions of patients achieving response or complete response at different time points were similar between groups overall but higher in the pred+IL group than in the pred alone group for newly diagnosed patients and those with severe ITP (P < .05). Posttreatment platelet count correlated negatively with platelet count at diagnosis and white blood cell (WBC) count at diagnosis in patients with newly diagnosed ITP (r = -0.337, P = .073 and r = -0.367, P = .050, respectively) or ITP with bleeding-related episodes (r = -0.357, P = .020 and r = -0.434, P = .004, respectively). No immediate or postinfusion severe adverse reactions were observed.rhIL-11 increased CR and improved hemostasis in patients with newly diagnosed or severe ITP. Platelet and WBC counts at diagnosis can predict the response to rhIL-11.

摘要

本研究评估了重组人白细胞介素-11(rhIL-11)治疗免疫性血小板减少症(ITP)的有效性,并确定临床和实验室检查结果是否能预测治疗反应。这项回顾性、单中心、病例对照研究纳入了2010年7月至2014年4月间在江西省人民医院接受治疗的103例成年ITP患者。约49例泼尼松联合IL组患者接受泼尼松(常规剂量)联合rhIL-11方案治疗,54例单纯泼尼松组患者仅接受泼尼松(常规剂量)治疗。比较了两组患者的人口统计学数据、初始和随访血小板计数、不同时间点血小板计数≥30×10⁹/L(反应)和≥100×10⁹/L(完全反应)的患者比例以及不良反应。总体而言,两组的完全缓解率相似,但新诊断患者和重度ITP患者中,泼尼松联合IL组的完全缓解率高于单纯泼尼松组(P<0.05)。总体而言,两组在不同时间点达到反应或完全反应的患者比例相似,但新诊断患者和重度ITP患者中,泼尼松联合IL组的比例高于单纯泼尼松组(P<0.05)。新诊断ITP患者或伴有出血相关发作的ITP患者中,治疗后血小板计数与诊断时血小板计数及诊断时白细胞(WBC)计数呈负相关(分别为r=-0.337,P=0.073和r=-0.367,P=0.050;或r=-0.357,P=0.020和r=-0.434,P=0.004)。未观察到即刻或输注后严重不良反应。rhIL-11可提高新诊断或重度ITP患者的完全缓解率并改善止血情况。诊断时的血小板和WBC计数可预测对rhIL-11的反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/678dcb8ef121/medi-98-e15195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/a4b1459c88be/medi-98-e15195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/30ca75df4c61/medi-98-e15195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/678dcb8ef121/medi-98-e15195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/a4b1459c88be/medi-98-e15195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/30ca75df4c61/medi-98-e15195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90e8/6494275/678dcb8ef121/medi-98-e15195-g004.jpg

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