A colleague in Australia wants to know if any e-network colleagues have had experience using Interleukin eleven (IL-11) in surgical patients with thrombocytopenia? IL-11 is a thrombopoietic growth factor that directly stimulates the proliferation of hematopoietic stem cells and megakaryocyte progenitor cells and induces megakaryocyte maturation resulting in increased platelet production. IL-11 is a member of a family of human growth factors which includes human growth hormone, granulocyte colony stimulating factor (G-CSF), and other growth factors. The inquiring Australian has a Jehovah's Witness patient who is thrombocytopenic and being prepared for liver transplantation; however, the patient does not want any blood transfusions. The hematologists are exploring IL-11 as a possible adjuvent modality and would like input from those with some experience. In the meantime, the patient has been placed on erythropoetin and the platelet count has come up from 20,000 to 85,000 per microliter.

The following responses have been received.

1. A transfusion medicine physician in Los Angeles reports that regarding the use of IL-11 in raising platelet counts for selected patients, his hospital used the drug in 3 patients in preparation for autologous stem cell transplants and found no beneficial effects. He adds that they have since abandoned its use in that setting.

ADDENDA Nov. 15, 2002

2. The original inquiring physician in Australia wishes to update e-Network colleagues with a recent case report by Ustun C. et al. (Ann Hematol Oct 2002) showing that IL-11 had normalized the platelet count of a thrombocytopenic Jehovah's Witness patient in preparation for surgery.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator