The Pharmaceutical Journal
Vol 270 No 7235 p181
8 February 2003

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The Lancet (www.thelancet.com)

Cytokine may provide new approach to managing sepsis in cancer patients

Treatment with recombinant human interleukin 11 (rhIL-11) reduces the frequency and load of bacteraemia in patients with haemological malignant disease receiving chemotherapy, researchers say.

The cytokine, thought to act by either protecting gastrointestinal cells from cytotoxic damage or by immunological mechanisms, could offer a new, non-antibiotic approach to managing sepsis in these patients.

Dr Michael Ellis, United Arab Emirates University, Al-Ain, and colleagues randomly assigned 40 patients with haemological malignant disease to receive either rhIL-11 50µg/kg or placebo subcutaneously daily from the day before starting chemotherapy until either resolution of neutropenia or for 21 days, whichever was longer. They found that fewer patients in the rhIL-11 group developed bacteraemia than those given placebo and the time to first bacteraemia event was also increased with rhIL-11.

The proportion of patients with fever of any cause was lower in the rhIL-11 group than in the placebo group, which was probably a result of a reduction in bacteraemic events.

The researchers comment that adverse events associated with rhIL-11 were infrequent, of low intensity, and easily manageable, apart from in one patient with hypersensitivity. "Therefore, the clinical benefits of rhIL-11 clearly outweigh the side effects," they say.

They add that larger trials should be done to confirm their findings (Lancet 2003;361:275).