| Objective: To explore the intervention of combined use of recombinant human interleukin-11（rhIL-11）and recombinant human granulocyte colony-stimulating factor（rhG-CSF）on the duration of chemotherapy-induced agranulocytosis in patients with hematological malignancies,and the influencing factors of agranulocytosis,febrile neutropenia（FN）and hospitalization time.Methods: The data of 97 patients diagnosed as hematological malignancies and treated with rhIL-11 and rhG-CSF after chemotherapy in the department of hematology of The first hospital of Lanzhou University from July 2017 to July 2020 were collected.The duration of agranulocytosis in different groups were compared by univariate analysis.The factors that may influence agranulocytosis duration,febrile neutropenia（FN）and hospitalization time were analyzed by regression analysis.Results:1.The duration of agranulocytosis in 97 patients was 6.47 ±2.93 days.The univariate analysis showed significant differences in agranulocytosis time among patients with a different disease,the number of chemotherapy cycle,time of occurrence of fever after rhG-CSF and rhIL-11 administration,and different white blood cell（WBC）count baseline levels（P<0.05）.Multiple linear regression analysis showed that chemotherapy cycles,fever after administration of rhG-CSF and rhIL-11,diagnosis of AML,and WBC baseline level were the influencing factors of the duration of agranulocytosis（P<0.05）.2.The incidence of FN in 97 patients was 58.8%.Univariate analysis showed that there were significant differences in FN incidence among patients with different ages,body weight,body mass index（BMI）,rhG-CSF dosage,rhIL-11 dosage,platelet（PLT）baseline,absolute neutrophil count（ANC）baseline and WBC baseline.Binary logistic regression analysis showed that high PLT baseline was a protective factor for FN.3.The hospitalization time in 97 patients was 21.56±4.52 days.Univariate analysis showed significant differences in hospitalization time among patients with a different disease,rhG-CSF dosage,rhIL-11 dosage and hemoglobin（HGB）baseline.Multiple linear regression analysis showed that the dosage of rhIL-11 was the influencing factor of hospitalization time.Conclusion: When treated by the combination of rhIL-11 and rhG-CSF,patients with the diagnosis of AML,more chemotherapy cycles,low WBC baseline and the late onset of fever after cytokines administration would experience prolonged agranulocytosis.Moreover,patients with a low baseline of PLT level before cytokines administration should receive enhanced infection prevention measures for the increased risk of FN.For the low dosage of IL-11 was related to the prolonged hospitalization time,the dosage of rhIL-11 should be sufficient in recommended dosage range.Compared with previous studies,the combination of rhG-CSF and rhIL-11 may further shorten the duration of agranulocytosis in AML patients receiving high-dose cytarabine chemotherapy than rhG-CSF alone. |
