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Interleukin-11 for treatment of hepatitis C-associated ITP
Vincenzo Fontana1, Pamela Dudkiewicz, Wenche Jy
1Wallace H. Coulter Platelet Laboratory, Division of Hematology/Oncology, Department of Medicine, University of Miami, Miller School of Medicine, Miami, Fla. 33136, USA.
Background:
Immune thrombocytopenic purpura (ITP) is frequently associated with chronic hepatitis C (HpC-ITP).
Methods:
Recombinant interleukin-11 (rIL-11), which has both thrombopoietic and anti-inflammatory properties, was evaluated in 12 patients with HpC-ITP in this pilot study. Group 1 (7 patients) was treated at high dose (50 microg/kg daily) while group 2 (5 patients) at low dose (15-35 microg/kg three/week).
Results:
In group 1, mean platelet counts rose from initial 54 x 10(9)/l to 103 x 10(9)/l (p = 0.02) and in group 2, from an initial 51 x 10(9)/l to 74 x 10(9)/l (p = 0.04). Antiplatelet antibody (aPlt-Ab) decreased in group 1. LFT improved in both groups. The mean HCV-RNA decreased in group 1 (p = 0.04), not in group 2. Side effects were common and troublesome, but were minimized with individualized dosing. One patient achieved good remission of both ITP and HpC lasting >2 years with low-dose maintenance.
Conclusion:
When used based on individual tolerance, rIL-11 appears useful in HpC-ITP.
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