Efficacy and Safety of rhIL-11 in the Treatment of Cancer Therapy-Induced Thrombocytopenia: A Multicenter Retrospective Study.

OBJECTIVE

This real-world study aimed to investigate the cancer therapy-induced thrombocytopenia (CTIT) profile and evaluate the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in its management.

METHODS

Retrospective analysis included 12,431 CTIT patients treated with rhIL-11 across 58 Chinese centers (July 2023-June 2024). Multivariate logistic regression analysis identified CTIT risk factors. Treatment outcomes and adverse events (AEs) were assessed.

RESULTS

Independent CTIT risk factors included advanced age, medical history, prior myelosuppression, tumor type, bone marrow involvement, and previous anti-tumor therapy. RhIL-11 demonstrated significant thrombopoietic effects, with a mean treatment duration of 6.79 ± 2.59 days. Platelet (PLT) recovery to 50 × 109/L and 100 × 109/L was 4.60 ± 4.40 days and 7.68 ± 5.09 days, respectively. Hematologic malignancy patients required longer treatment and slower PLT recovery compared to those with solid tumors. Urologic and head/neck malignancy patients had faster recovery, while uterine, colorectal, and liver cancer patients exhibited poorer outcomes. Fluoropyrimidine monotherapy delayed PLT recovery compared to platinum-, taxane-, anthracycline-based regimens, or gemcitabine/platinum combinations (all p < 0.05). Furthermore, patients with "impaired" PLT recovery capacity or grade IV CTIT demonstrated longer treatment and PLT recovery times, while grade I/III CTIT was associated with higher PLT recovery response rates. AEs occurred in 28.9% of patients, primarily mild fatigue (15.3%) and edema (7.5%). COVID-19 infection correlated with prolonged treatment duration and delayed PLT normalization.

CONCLUSION

This large-scale real-world study confirms the efficacy and safety of rhIL-11 in CTIT management. Treatment responses vary slightly across patient subgroups, but tolerability remains acceptable. Findings emphasize individualized CTIT strategies and proactive AEs monitoring.