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目的探索重组人粒细胞集落刺激因子(rh G-CSF)联合重组白细胞介素11(rh IL-11),治疗急性淋巴细胞白血病(ALL)患者大剂量化疗后全血细胞减少的疗效、安全性及其可能的机制。方法将32例ALL患者分为单用A组、单用B组和联合组,大剂量化疗结束48 h后A组单纯使用rh G-CSF治疗,B组单纯给予rh IL-11治疗,联合组接受rh G-CSF和rh IL-11联合治疗。治疗10 d后比较3组患者血细胞数量,同时检测各组骨髓单核细胞G-CSF受体(G-CSFR)和IL-11受体(IL-11R)表达水平。结果 rh G-CSF和rh IL-11联合较单纯使用能够更明显提高ALL患者大剂量化疗后血细胞数量。治疗后各组骨髓单核细胞G-CSFR和IL-11R基因及蛋白水平均有提高,其中联合使用组提高的幅度更明显,差异均有统计学意义(P<0.05)。使用Spearman法分析发现G-CSFR和IL-11R的表达存在正相关性。结论 rh G-CSF和rh IL-11联合使用可以明显提高ALL患者化疗后G-CSFR和IL-11R的水平,其可能是改善化疗引起骨髓抑制的作用机制之一。
Objective To investigate the efficacy and safety of recombinant human granulocyte colony-stimulating factor (rhG-CSF) combined with recombinant interleukin-11 (rhIL-11) in the treatment of pancytopenia after high-dose chemotherapy in patients with acute lymphoblastic leukemia Its possible mechanism. Methods 32 cases of ALL patients were divided into group A, group B and combination alone. Group A was treated with rhG-CSF only after 48 hours of high-dose chemotherapy, group B was treated with rh IL-11 alone, Received rh G-CSF and rh IL-11 combination therapy. After 10 days of treatment, the number of blood cells in the three groups was compared. The expression of G-CSFR and IL-11R in each group was also measured. Results The combination of rhG-CSF and rhIL-11 could significantly increase the number of blood cells after high-dose chemotherapy in ALL patients. After treatment, the levels of G-CSFR and IL-11R gene and protein in all groups increased, especially in combination group. The difference was statistically significant (P <0.05). Spearman analysis showed that there was a positive correlation between the expression of G-CSFR and IL-11R. Conclusion The combination of rhG-CSF and rhIL-11 can significantly increase the levels of G-CSFR and IL-11R after chemotherapy in ALL patients, which may be one of the mechanisms of improving chemotherapy-induced myelosuppression.