Pilot Study of Low-Dose Interleukin-11 in Patients With Bone Marrow Failure

Abstract

Our pilot study suggests that administration of low-dose IL-11 (10 microg/kg/d) can raise platelet counts without significant toxicity in selected thrombocytopenic patients with bone marrow failure.

Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes

“…[4][5][6][7] Therapeutic options are limited. 8 Management strategies used in MDS include growth factors [9][10][11][12][13][14][15][16][17][18] and chemotherapy, [19][20][21] as well as supportive care with antibiotics and transfusions. 22 Allogeneic transplantation, although potentially curative, is a realistic option for only a small proportion of these patients due to patient age and the limited availability of appropriate donors.…”

Sequential interleukin 3 and granulocyte‐macrophage–colony stimulating factor therapy in patients with bone marrow failure with long‐term follow‐up of responses

“…A similar delay in platelet recovery has been seen in our studies with SCF in patients with AA 29 and in patients with bone marrow failure treated with low-dose IL-11. 27 These results suggest that the temporal response paradigm of G-CSF and GM-CSF, in which administration of growth factors is followed by a neutrophil response within 24 hours, may not be applicable when other, earlier acting growth factors are used. Alternatively, the fact that delayed platelet responses have been observed with several distinct growth factor regimens may indicate that the physiology and, hence, the time course of platelet recovery after administration of thrombopoietic agents is fundamentally different from that of neutrophils.…”

“…31 Combinations of erythropoietin together with myeloid growth factors usually have demonstrated only bilineage responses, although occasional platelet recovery is noted. 38 Still, IL-11 may increase platelet counts in a subset of patients with MDS or AA, 27 and durable multilineage recovery has been observed in some patients with AA who were treated with SCF. 29 Taken together, these results suggest that both platelet and multilineage responses are achievable in bone marrow failure but that additional molecules warrant investigation.…”

“…Recent studies suggest that low doses of interleukin 11 (IL-11) may induce platelet responses in 35-40% of patients. 27 Similarly, preliminary trials suggest that stem cell factor (SCF) may induce platelet and multilineage responses in patients with AA. 28,29 IL-3 alone, however, has very limited activity.…”

Novel therapies for myelodysplastic syndromes

“…A recent report indicated platelet responses in 38% of patients with MDS who received low doses of IL-11 (10 g/kg daily). 52 Pegylated recombinant human megakaryocyte growth and development factor (MGDF) stimulates megakaryopoiesis in vitro and increases platelet counts in healthy volunteers and in patients with cancer after chemotherapy. In a Phase I/II study, MGDF was given intravenously daily for 14 days to 16 patients with aplastic anemia (AA) and to 21 patients with MDS (RA and RARS).…”