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 20×10⁹/L, the days it takes for PLT to recover to more than 100×10⁹/L, and the incidence of different bleeding degrees were compared among several groups. RESULTS: The duration of PLT<20×10⁹/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<20×10⁹/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 100×10⁹/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 100×10⁹/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.
Humans ; Interleukin-11 ; Leukemia, Myeloid, Acute/drug therapy* ; Platelet Count ; Recombinant Proteins/therapeutic use* ; Retrospective Studies ; Thrombocytopenia ; Thrombopoietin/therapeutic use*

Traditional treatment of chronic idiopathic thrombocytopenic purpura (CITP) is usually adopted as hormonal therapy. If necessary, it also can be given immunosuppressive therapy. In order to investigate the curative effect of rhIL-11 on patients with ITP, 26 patients were divided into control group and rhIL-11 group, each group with 13 patients. Control group was given traditional hormonal therapy and immunosuppressive therapy, while rhIL-11 group was given rhIL-11 on base of traditional therapy. rhIL-11 25 microg/(kg.d) was injected s.c. for 28 days. The results showed that 23 out of 26 patients obtained obviously curative effect in platelet count, especially in rhIL-11 group, but another 3 patients had no response on therapy. The platelet counts of control and rhIL-11 groups increased from 26.15 x 10(9)/L and 27.84 x 10(9)/L before treatment to 66.62 x 10(9)/L and 105.62 x 10(9)/L after treatment. The platelet count of rhIL-11 group after treatment was remarkably higher than that of the control group (p < 0.05). Platelet count of 8 patients in rhIL-11 group recovered to normal. It is concluded that rhIL-11 combined with traditional hormone-immuno-suppressive therapy is effective to CITP.
Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Interleukin-11 ; therapeutic use ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; therapy ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

In order to evaluated the curative effect of rhIL-11 (Mega) on thrombocytopenia in chronic aplastic anemia (CAA) patients, ten CAA cases with thrombocytopenia after administration of conventional drugs were selected and subcutaneously injected 0.75 mg Mega per day in 1 - 2 courses of treatment on the basis of conventional therapy. Results showed that platelet counts were obviously increased and the bleeding symptoms were alleviated in all CAA patients after application of Mega for treatment. In conclusion, the rhIL-11 (Mega) could be used as an effective drug for treatment of thrombocytopenia in CAA patients.
Adolescent ; Adult ; Anemia, Aplastic ; blood ; therapy ; Chronic Disease ; Female ; Humans ; Interleukin-11 ; therapeutic use ; Male ; Middle Aged ; Platelet Count ; Recombinant Proteins ; therapeutic use ; Thrombocytopenia ; blood ; therapy

The aim of this study was to investigate the circulating levels of IL-11 in the patients with chronic idiopathic thrombocytopenic purpura (CITP), and its significance, and to evaluate the curative effect of rhIL-11 on CITP. The level of IL-11 in patients with CITP was determined by ELISA before and after treatment, respectively. 1.5 mg of rhIL-11 were injected subcutaneously, once a day, continuously for 14 days as one course, treatment time 1 - 2 courses as total. The results showed that the higher blood IL-11 level was found in CITP patients than that in controls (P < 0.01) and during the course of treatment the number of platelets in peripheral blood of patients with CITP parallelled to the level of IL-11. The platelet counts were obviously increased in all CITP patients after rhIL-11 treatment. It is concluded that the serum level of IL-11 in patients is correlated to the number of platelets in patients. rhIL-11 can be used as an effective treatment for CITP.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Interleukin-11 ; blood ; therapeutic use ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

OBJECTIVE: To explore the intervention effect of recombinant human interleukin-11 (rhIL-11) and recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the duration and severity of agranulocytosis in patients with hematological malignancies after chemotherapy, and to analyze the influencing factors. METHODS: The data of hematological malignancy patients treated with rhIL-11 and rhG-CSF after chemotherapy in the hematology department of The First Hospital of Lanzhou University from July 2017 to July 2020 were collected retrospectively. The duration and differences of agranulocytosis in differeent groups were compared by univariate analysis, and the influencing factors of agranulocytosis duration were further analyzed by multiple regression analysis. RESULTS: The duration of agranulocytosis in 97 patients was 6.47±2.93 days. The results of univariate analysis showed that there were no statistical differences in the duration of agranulocytosis among patients with different sex, age, height, weight, body surface area, body mass index (BMI), dose of rhG-CSF, dose of rhIL-11, spontaneous bleeding after administration of rhG-CSF and rhIL-11, and the duration of agranulocytosis in patients with different red blood cell count (RBC), hemoglobin(HGB) level, platelet count (PLT) and absolute neutrophil count (ANC), before administration of rhG-CSF and rhIL-11. There were significant differences in agranulocytosis time among patients with different disease types, chemotherapy cycle, fever after rhG-CSF and rhIL-11 administration, and different white blood cell count (WBC) baseline level before rhG-CSF and rhIL-11 administration (P＜0.05). Compared with patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL), patients with acute myeloid leukemia (AML) had the longest duration of agranulocytosis, which was 7.07±3.05 d. Compared with patients with chemotherapy cycles of 4－6 and ≥7, patients with total chemotherapy cycle of 1－3 had the shortest duration of agranulocytosis, which was 5.25±2.48 d. Compared with patients without fever, patients with fever within 1 day after administration of cytokines and patients with fever within 2-5 days after administration of cytokines, the duration of agranulocytosis was the longest in patients with fever 6 days after administration of cytokines, which was 8.85±2.85 d. Compared with patients with WBC baseline <1.0×10⁹/L, (1.0－1.9)×10⁹/L and (2.0－3.9)×10⁹/L, patients with WBC baseline ≥4.0×10⁹/L had the shortest duration of agranulocytosis, which was 4.50±2.56 d. Multiple linear regression analysis showed that chemotherapy cycle, different fever after administration of rhG-CSF and rhIL-11, diagnosis of ALL and NHL, and WBC baseline level before administration of rhG-CSF and rhIL-11 were the influencing factors of the duration of agranulocytosis (P＜0.001). CONCLUSION The risk of prolonged agranulocytosis is higher in patients diagnosed with AML, with more chemotherapy cycles, lower WBC baseline before cytokines administration and fever later after cytokines administration, which should be paid more attention to.
Agranulocytosis ; Granulocyte Colony-Stimulating Factor/therapeutic use* ; Hematologic Neoplasms/drug therapy* ; Humans ; Interleukin-11 ; Lymphoma, Non-Hodgkin/drug therapy* ; Recombinant Proteins/therapeutic use* ; Retrospective Studies

OBJECTIVETo study the therapeutic efficacy of multigly-cosidorum Tripterygium combined with rhIL-11 for treating patients with immune thrombocytopenia (ITP).

METHODSA total of 75 patients with ITP were divided into 2 group: experimental group and control group. The experimental group included 40 patients who had been treated with multigly-cosidorum Tripterygium combined with rhIL-11. Multigly-cosidorum Tripterygium was given at a dose of 1mg/kg·d for 2 months and rhIL-11 was injected at a dose of 16,000,000 units per day. Control group included 35 patients who had been treated with prednisone at a dose of 1 mg/kg·d. Platelet counts were performed every day before platelet counts >30 × 10⁹/L. Peripheral blood T cells were collected before and after treated for 2 months. The ratios of CD4⁺, CD8⁺ T cells in peripheral blood T cells were analyzed by flow cytometry.

RESULTSTotally effective rate in experimental group was 77.5%. Totally effective rate in control group was 82.9%. Totally effective rate showed no statistical difference between these two groups (P > 0.05). The average time of platelet count 30 × 10⁹/L in experimental and control groups were 13.06 ± 6.10 days and 9.76 ± 5.71 days respectively; in experimental group, the ratio of CD4⁺ T cells in peripheral blood was 21.03% before treatment, then rised to 34.49% after treatment for 2 months (P < 0.01); The ratio of CD8⁺ T cells in peripheral blood was 26.35% before treatment, then decreased to 20.18% (P < 0.01). In control group, the ratio of CD4⁺ T cells was 22.30% before treatment, then rised to 25.11% after treatment for 2 months (P < 0.05); The ratio of CD8⁺ T cells in peripheral blood was 27.24% before treatment, then decreased to 21.35% (P < 0.01).

CONCLUSIONMultigly-cosidorum tripterygium can correct disorder of T lymphocytes, the combination of multigly-cosidorum triptergium and rhIL-11 can accelerate therapeutic efficacy for treating ITP and with less adverse reaction, so this combination may be effective and safe for treating patients with ITP.

Antineoplastic Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Interleukin-11 ; therapeutic use ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; therapeutic use ; T-Lymphocytes ; Tripterygium ; chemistry

OBJECTIVE: To analyze the relationship between serum miR-34a level and thrombocytopenia after chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL). METHODS: A total of 69 eligible DLBCL patients who received chemotherapy in our hospital from January 2018 to January 2020 were prospectively included as the research subjects, all patients received R-CHOP 21 regimen (rituximab + cyclophosphamide + adriamycin + vincristine + prednisone) for chemotherapy, 3 weeks was 1 cycle, and 2 cycles of chemotherapy were used. The patients were divided into a reduction group and a non reduction group according to whether there was thrombocytopenia after chemotherapy, the general data and laboratory indexes of the two groups were investigated and compared, the relationship between serum miR-34a before chemotherapy and thrombocytopenia after chemotherapy in patients was analyzed. RESULTS: Among the 69 DLBCL patients, 36 patients developed thrombocytopenia after 2 cycles of R-CHOP 21 regimen for chemotherapy, the incidence was 52.17%; the level of serum IL-11 and the relative expression of miR-34a mRNA in the reduction group were significantly lower than the non reduction group (P<0.05), compared other data between groups, there was no statistical significant difference (P>0.05); after Logistic regression analysis, the results showed that the level of serum IL-11 and the relative expression of miR-34a mRNA were related to thrombocytopenia after chemotherapy in DLBCL patients, low expression of each index may be a risk factor of thrombocytopenia after chemotherapy in DLBCL patients (OR>1, P<0.05); ROC curve was drawn, and the results showed that the AUC of serum IL-11 level and miR-34a mRNA relative expression before chemotherapy alone and in combination predicted the risk of thrombocytopenia after chemotherapy in DLBCL patients were all >0.80, and the predictive value was ideal, when the cut-off value of serum IL-11 level before chemotherapy was 42.094 pg/ml, and the cut-off value of miR-34a mRNA relative expression was 3.894, the combined prediction value was the best. CONCLUSION The relative expression of miR-34a mRNA is associated with thrombocytopenia after chemotherapy in DLBCL patients, which may be a risk factor for thrombocytopenia in patients after chemotherapy, has certain value in predicting the risk of thrombocytopenia of patients after chemotherapy.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Cyclophosphamide ; Doxorubicin ; Humans ; Interleukin-11/therapeutic use* ; Lymphoma, Large B-Cell, Diffuse/genetics* ; MicroRNAs/genetics* ; Prednisone/therapeutic use* ; Prognosis ; RNA, Messenger ; Rituximab/therapeutic use* ; Thrombocytopenia ; Vincristine

Interleukin-11 (IL-11) is a multifunctional cytokine that directly acts on hematopoietic progenitors, macrophage, T cells, epithelial cells and hepatocytes, as well as promotes hematopoiesis, regulates immunity, protects mucosa and epithelium, and has the effect of anti-inflammatory. Preclinical and clinical studies have demonstrated that IL-11 effectively accelerates the recovery of peripheral blood platelets of acute leukemia patients after chemotherapy. In the hematopoietic stem cell transplantation, IL-11 prevents and treats the graft-versus-host disease leading to the effect of graft-versus-leukemia. Synergizing with G-CSF, IL-11 mobilizes hematopoietic progenitors and stem cells from bone marrow to peripheral blood with higher efficiency. Progress on research and clinical application of IL-11 in treatment of leukemia was reviewed in this paper.
Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Interleukin-11 ; adverse effects ; pharmacology ; therapeutic use ; Kidney ; drug effects ; Leukemia ; drug therapy ; Liver ; drug effects

OBJECTIVETo investigate the efficacy, safety and possible mechanism of rhIL-11 in the management of chemotherapy-induced thrombocytopenia in acute leukemia.

METHODSThirty-two acute leukemia patients were enrolled in the study. rhIL-11 was given when platelet count dropped below 30 x 10(9)/L after chemotherapy, at 1.5 mg/d, ih, for 7-14 days or withdrawn when the increase of platelet count was more than 50 x 10(9)/L. Serum IL-11 level was determined by ELISA, IL-11R alpha gene expression by RT-PCR. Efficacy and safety data were collected and their correlation with serum IL-11 and IL-11Ralpha expression were analyzed.

RESULTSThe platelet counts on day 7 and 14 after medication were (63.40 +/- 7.24) x 10(9)/L and (98.70 +/- 9.37) x 10(9)/L for 32 patients in IL-11 group [26 complete remission (CR), 2 partial remission (PR), 4 non-remission (NR)] and (42.50 +/- 6.38) x 10(9)/L and (70.30 +/- 7.12) x 10(9)/L for the control group (20 CR, 3 PR, 5 NR). There were 10 patients who received platelet transfusion (16-32 U) in IL-11 group and 19 patients (32-48 U) in control group. Compared with the IL-11 group a delay of platelet recovery was observed in controls (P < 0.05). IL-11 was generally well tolerated. Five experienced transient atrial arrhythmia and relieved after extenuation or withdrawal. The responders' serum IL-11 level of pre-medication was (21.81 +/- 1.88) ng/L, lower than that of non-responders (P < 0.05). IL-11Ralpha level was 0.3552 +/- 0.0224, higher than that of non-responders (P < 0.05). No correlation was observed among serum IL-11, IL-11Ralpha expression, platelet count, and megakaryocyte number.

CONCLUSIONSrhIL-11 can safely accelerate the recovery of chemotherapy-induced thrombocytopenia in acute leukemia. The serum IL-11 level and IL-11Ralpha of mononuclear cells might predict the efficacy of rhIL-11.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Female ; Humans ; Interleukin-11 ; therapeutic use ; Leukemia ; drug therapy ; Male ; Middle Aged ; Thrombocytopenia ; chemically induced ; drug therapy

OBJECTIVETo evaluate the efficacy and toxicity of domestic recombinant human interleukin-11 (rhIL-11) in the prevention of chemotherapy-induced thrombocytopenia.

METHODSA randomized, self-crossover and placebo-controlled trial was conducted, with rhIL-11 and placebo classified randomly as drug A and drug B. Patients were randomly assigned to group AB or group BA. 25 microg/kg body weight of drug A or drug B was administered subcutaneously once daily starting 24 hours after chemotherapy and continued for 7 to 14 days or until the platelet count reached > or = 300 x 10(9)/L.

RESULTS118 patients were evaluable in the efficacy study. When compared with the placebo treated cycle, the results showed that rhIL-11 was able to significantly increase the platelet count at the nadir and d21 after chemotherapy, with a increase of 60.7% and 86.1% (both P < 0.001). The mean duration of thrombocytopenia (< 100 x 10(9)/L) in rhIL-11 treated cycle was 1.0 +/- 2.0 days as compared to 6.9 +/- 5.3 days in placebo treated cycle. The side effects were ache (24.6%), swelling (16.1%) and knurl (11.9%) at the injection site, hyperaemia of conjunctiva (16.1%), edema (8.5%), palpitation (6.8%) and fatigue (5.1%).

CONCLUSIONrhIL-11, possessing significant thrompoietic activity, significantly increases the likelihood of avoiding chemotherapy-induced thrombocytopenia and shorten the duration of thrombocytopenia. Its side effects are mild and manageable.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; adverse effects ; Cross-Over Studies ; Double-Blind Method ; Humans ; Interleukin-11 ; adverse effects ; therapeutic use ; Middle Aged ; Neoplasms ; blood ; drug therapy ; Recombinant Proteins ; therapeutic use ; Thrombocytopenia ; prevention & control