Clinical Observation On Using Interleukin-11for The Treatment Of Thrombocytopenia Induced By Cancer Chemotherapy

Background and purposeThe chemotherapy of malignant tumor patients often cause varying degrees of thrombocytopenia (Platelet, PLT) to affect the process of cancer treatment and a bring heavier financial burden for patients. Studies have shown that interleukin-11(IL-11) can effectively treat the thrombocytopenia induced by cancer chemotherapy because it can not only significantly increase the number of peripheral PLT of patients but also significantly shorten the PLT recovery time. We collected132cases of the thrombocytopenia patients of our hospital who entered the hospital form Jun2008to Sep2011and whose pathological results were Ⅲ-Ⅳ non-small-cell carcinoma, gastric cancers and ovarian cancers. We divided them into the experimental groups and control groups, and then gave them IL-11treatments, observing and evaluating of the clinical efficacy and safety of using IL-11treatment for cancer patients who got the thrombocytopenia after chemotherapy.Materials and Methods Clinical dataWe collected132cases of patients who entered the hospital form Jun2008to Sep2011and whose pathological and immunohistochemical diagnosis results are non-small-cell carcinoma, gastric cancers and ovarian cancers from the Department of Oncology of the First Affiliated Hospital of Zhengzhou University. We took the self-control method to observe on the efficacy and safety to use interleukin-11for the treatment of thrombocytopenia induced by cancer chemotherapy. We used the "paclitaxel&carboplatin" method as their chemotherapy regimens (Paclitaxel150mg/m2, intravenous infusion for3hours at the first day; carboplatin AUC5, intravenous infusion for2hours at the second day, every21days as one cycle). All patients as stage III-IV patients were previously untreated and their ages are within18-65years; their expected natural survival times are4months or more; KPS scored80, after the end of the first cycle of chemotherapy,15×109/L≤the PLT≤50×109/L; they accepted at least two cycles of chemotherapy with the same programs; after the resumption, of the highest value the PLT counting≤350×109/L; no chemotherapy contraindications (hemoglobin≥90g/L, absolute neutrophil counting≥1.5×109/L, platelets≥100×109/L, alanine aminotransferase (ALT), aspartate aminotransferase times of the normal upper limits, serum total bilirubin≤1.5times of the normal upper limits, serum creatinine≤1.5times of the upper normal limits, serum albumin≥30g/L); The major organs such as heart, lung have no serious dysfunctions; no acute infections, thrombosis and active bleeding history; all patients signed notices of informed consent, chemotherapy consent.Delivery methodsWe took the self-control methods, that is we monitored the patients with peripheral PLT value at the end of the first chemotherapy treatment, and patients whose PLT≤50×109/L would be divided to the control group. We required the minimum value of PLT counting of the patients of this group must be within15the ×109/L-50×109/L during the chemotherapy. When their PLT counting recovered to100×109/L, they would receive the second cycles of chemotherapy with the same regimen and dose. After the end of the second cycle of chemotherapy, the peripheral PLT counting values were taken as the values of experimental group. We gave everyone of them1.5mg/d of IL-11by subcutaneous injection when their peripheral PLT counting is less than50×109/L, the days for injecting every day of IL-11should be determined by bone marrow inhibition of patients, and we should stop the injection in next day when the PLT counting increased to80×109/L. The third cycle and the fourth cycle of treatment are same with the first cycle and second cycle, and so on. If the PLT value was low than15×109/L or presents with bleeding tendency, clinically give PLT transfusion or symptomatic treatment to stop bleeding. Blood routine should be examined daily When the PLT value reduce to15×109/L-30×109/L, blood routine should be examined every other day when the PLT value reduce to30×109/L-80×109/L, to monitor the PLT levels.Statistical methods SPSS17.0software was used in Statistical analysis and treatments. Two samples were come from normal population and homoscedasticity, t test was applied for difference comparison among measurement data. P<0.05means the difference was statistically significant, P>0.05means difference was not statistically significant.ResultsThrough the chemotherapy, the132cases of non-small-cell carcinoma, stomach cancer and ovarian cancer patients who present PLT reduction, then use the IL-11, and results showed that, the lowest value of the PLT in the treatment group is (21.81±2.43X109/L, and was significantly higher than the value of (15.24.±3.26)×109/L in control group, the difference was statistically significant (P<0.05); the highest values of the treatment group and control group is (310.87±22.32)×109/L and(195.63±35.75)×109/L respectively, the highest value of the treatment group and control group present difference (P<0.05); the PLT value of the treatment and control group has increased (297.68±23.25)×109/L and (187.45±29.67)×109/L respectively, the difference between2groups was statistically significant (P<0.05); the treatment group and control group sustained at50×109/L<PLT≤80×109/L for (10.29±3.26) d and (15.56±3.65) d respectively; the difference between2groups was statistically significant (P<0.05); and sustained at30×109/L<PLT≤50×109/L for (8.13±3.09) d and (12.29±4.12) d respectively, the difference between2groups was statistically significant (P<0.05); and sustained at15×109/L≤PLT≤30×109/L for (5.78±2.65) d and (9.17±3.94) d respectively, the difference between2groups was statistically significant (P<0.05);19cases patients in treatment group was carried out PLT transfusion for one time, and47cases patients in control group, the difference between2groups was statistically significant (P<0.05). In this study,60cases/once patients appeared adverse reactions related to IL-11, includes12case/once (8.7%) appeared local adverse reactions at the transfusion site,7case/once (5.1%) appeared conjunctival hyperemia,9case/once (6.5%) appeared palpitations,8case/once (5.8%) appeared fatigue,10case/once (7.2%) appeared low fever,8case/once (5.8%) appeared rash, and6case/once (4.3%) appeared edema, and these adverse reactions on patients present mild and can be tolerated, no special treatment was carried out, and the adverse reactions self-disappeared after discontinuation of drugs.ConclusionIL-11presents clear curative effect and high safety on treatment of PLT reduction of malignant tumors after chemotherapy.