What question did this study set out to answer?

To evaluate the cardiac effects of prolonged recombinant human interleukin-11 treatment in patients with severe thrombocytopenia by comparing cardiac biomarkers and arrhythmia rates with rhTPO.

July 22, 2026BMC Pharmacology and Toxicology0 citationsOpen Access

Cardiac effects of prolonged recombinant human interleukin-11 treatment in severe thrombocytopenia: a retrospective cohort study

XLXianfa Li YSYue Sun WWWenrong Wang

Key Points

To evaluate the cardiac effects of prolonged recombinant human interleukin-11 treatment in patients with severe thrombocytopenia by comparing cardiac biomarkers and arrhythmia rates with rhTPO.
Retrospective cohort study of adults treated with rhIL-11 or rhTPO for ≥ 5 days from 2015 to 2021.
Data collection focused on BNP levels and arrhythmia occurrences at baseline, during treatment, and post-discontinuation.
Statistical analyses, including Kaplan-Meier and multivariate COX regression, compared outcomes between treatment groups.
The rhIL-11 group had a significant increase in BNP levels from 418 pg/mL to 3084 pg/mL (P < 0.01) within one week, whereas the rhTPO group showed no significant changes (P = NS).
34.8% of rhIL-11 patients developed cardiac arrhythmias, particularly after two weeks of treatment; 100% of those treated over three weeks experienced complications like ventricular tachycardia.
Kaplan-Meier analysis showed significant differences in arrhythmia risk profiles between rhIL-11 and rhTPO groups (P < 0.05).

Abstract

Abstract Background Recombinant human interleukin-11 (rhIL-11) is commonly used to treat thrombocytopenia induced by cancer chemotherapy. However, concerns about its potential cardiac side effects, especially with prolonged use, warrant further investigation. Aim This study aimed to evaluate the cardiac effects of prolonged rhIL-11 use by comparing changes in cardiac biomarkers and arrhythmia rates between rhIL-11 and recombinant human thrombopoietin (rhTPO) in patients with severe thrombocytopenia. Method We conducted a retrospective cohort study of adult patients treated with rhIL-11 or rhTPO for ≥ 5 days between 2015 and 2021. Data were collected at baseline, during treatment, and after discontinuation, focusing on BNP levels and arrhythmia occurrences. Statistical analyses were performed to compare the outcomes between the two groups. Results Our study cohort comprised 23 patients treated with rhIL-11 and 7 patients receiving rhTPO. The rhIL-11 group showed a significant increase in serum BNP levels from a baseline median of 418 pg/mL (IQR: 193–1205) to 3084 pg/mL (IQR: 1446–5000) within one week ( P < 0.01), while the rhTPO group had no significant changes ( P = NS). BNP levels in the rhIL-11 group decreased to 384.0 pg/mL (IQR: 239.0–460.0) one week post-discontinuation ( P < 0.05). Cardiac arrhythmias were documented in 34.8% (8/23) of rhIL-11-treated patients, demonstrating a clear treatment duration-dependent pattern: 83.3% (5/6) of patients receiving rhIL-11 for more than two weeks developed arrhythmias, with all 3 patients (100%) treated beyond three weeks experiencing cardiac complications, including two cases of frequent ventricular tachycardia. The rhTPO group showed no significant BNP changes or arrhythmic events. Kaplan-Meier survival analysis revealed a statistically significant divergence in arrhythmia risk profiles between the two treatment groups ( P < 0.05). Multivariate COX regression analysis identified age as an independent risk factor for arrhythmia development (HR 1.071, 95% CI: 1.007–1.139; p = 0.029). Conclusions Prolonged rhIL-11 treatment was associated with significant elevations in BNP levels and a higher incidence of arrhythmias, particularly with longer treatment durations. These findings highlight the need for close cardiac monitoring in patients receiving extended rhIL-11 therapy. Further large-scale, prospective studies are necessary to establish clear cardiac safety guidelines for rhIL-11 use.

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