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[重组人血小板生成素和重组人白细胞介素-11对白血病化疗后血小板减少症的影响]

[Effect of rhTPO and rhIL-11 on Thrombocytopenia after Chemotherapy in Leukemia].

作者信息

Dai Ji-Fei, Xia Rui-Xiang

机构信息

Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.

Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Jun;30(3):711-717. doi: 10.19746/j.cnki.issn.1009-2137.2022.03.008.

Abstract

OBJECTIVE

To analyze and compare the efficacy of recombinant human thrombopoietin (rhTPO) and recombinant human interleukin-11 (rhIL-11) in the treatment of thrombocytopenia after chemotherapy in acute leukemia patients.

METHODS

180 patients with acute leukemia complicated with thrombocytopenia after chemotherapy in the First Affiliated Hospital of Anhui Medical University were analyzed retrospectively. Among them, 50 patients who treated with rhTPO and did not receive platelet transfusion were set as group A, 50 patients treated with rhTPO and receive platelet transfusion were set as group B, Forty patients treated with rhIL-11 without platelet transfusion were set as group C, Forty patients who treated with rhIL-11 and received platelet transfusion were set as group D. The duration of PLT below 20×10/L, the days it takes for PLT to recover to more than 100×10/L, and the incidence of different bleeding degrees were compared among several groups.

RESULTS

The duration of PLT<20×10/L in group A(3.72±1.14 d) was significantly shorter than that in group C(4.93±1.33 d) (P<0.001), and there was no significant difference from group B (P>0.05). The duration of PLT<20×10/L in group B(3.06±0.91 d) was significantly shorter than that in group D(4.65±0.98 d) (P<0.001), while the difference in duration of days between group C and D was not statistically significant (P>0.05). The times for PLT to recover to 100×10/L in group A(13.46±1.67 d) were significantly shorter than that in group C(16.85±2.13 d) (P<0.05), but there was no significant difference from group B (P>0.05). The time required for PLT to recover to 100×10/L in group B(13.36±1.49 d) were significantly shorter than that in group D(16.18±1.78 d) (P<0.05), while the difference in the days required for group C and group D was not statistically significant (P>0.05). The incidence of high bleeding risk in group B was significantly lower than that in group A (22% vs 44%, P<0.05), the incidence of high bleeding risk in group D was significantly lower than that in group C (32% vs 65%, P<0.05), and the incidence of high bleeding risk in group A was significantly lower than that in group C (44% vs 65%, P<0.05). The incidence of high bleeding risk in group B(22%) was lower than that in group D(32.5%), and the difference was not statistically significant (P>0.05).

CONCLUSION

In the treatment of acute leukemia patients with thrombocytopenia after chemotherapy, compared with rhIL-11, rhTPO can significantly shorten the duration for patients in a status with extremely low levels of PLT and the recovery time of PLT to normal range. In addition, PLT transfusion cannot speed up the time for patients to raise platelets to a safe range, nor can it shorten the duration of low PLT levels, but it can reduce the incidence of high bleeding risk events.

摘要

目的

分析比较重组人血小板生成素(rhTPO)与重组人白细胞介素-11(rhIL-11)治疗急性白血病患者化疗后血小板减少症的疗效。

方法

回顾性分析安徽医科大学第一附属医院180例急性白血病化疗后并发血小板减少症的患者。其中,50例接受rhTPO治疗且未输注血小板的患者设为A组,50例接受rhTPO治疗且输注血小板的患者设为B组,40例接受rhIL-11治疗且未输注血小板的患者设为C组,40例接受rhIL-11治疗且输注血小板的患者设为D组。比较各组血小板计数(PLT)低于20×10⁹/L的持续时间、PLT恢复至100×10⁹/L以上所需天数以及不同出血程度的发生率。

结果

A组PLT<20×10⁹/L的持续时间(3.72±1.14天)显著短于C组(4.93±1.33天)(P<0.001),与B组相比差异无统计学意义(P>0.05)。B组PLT<20×10⁹/L的持续时间(3.06±0.91天)显著短于D组(4.65±0.98天)(P<0.001),而C组和D组在持续天数上的差异无统计学意义(P>0.05)。A组PLT恢复至100×10⁹/L的时间(13.46±1.67天)显著短于C组(16.85±2.13天)(P<0.05),与B组相比差异无统计学意义(P>0.05)。B组PLT恢复至100×10⁹/L所需时间(13.36±1.49天)显著短于D组(16.18±1.78天)(P<0.05),而C组和D组所需天数的差异无统计学意义(P>0.05)。B组高出血风险发生率显著低于A组(22%对44%,P<0.05),D组高出血风险发生率显著低于C组(32%对65%,P<0.05),A组高出血风险发生率显著低于C组(44%对65%,P<0.05)。B组高出血风险发生率(22%)低于D组(32.5%),差异无统计学意义(P>0.05)。

结论

在治疗急性白血病化疗后血小板减少症患者时,与rhIL-11相比,rhTPO可显著缩短患者PLT极低水平状态的持续时间以及PLT恢复至正常范围的时间。此外,输注PLT并不能加快患者血小板升至安全范围的时间,也不能缩短PLT低水平持续时间,但可降低高出血风险事件的发生率。

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