Interferon alfa-2b in acute- and chronic-phase chronic myelogenous leukaemia: Initial response and long-term results in 54 patients

Norbert Niederle , Thomas Moritz , Otto Kloke , Ursula Wandl , Dieter May , Reinhardt Becher , Thomas Franz , Bertram Opalka , Carl Gottfried Schmidt
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引用次数: 14

Abstract

Fifty-four patients with Ph1-positive chronic myelogenous leukaemia (CML) (48 with chronic-phase and six acute-phase disease) were treated with interferon alfa-2b subcutaneously (s.c.). The starting dose was 4 million units (MU)/m2 body surface area daily. It was reduced in parallel with serially determined leucocyte counts, and minimal effective doses were given as maintenance after achieving remission. Haematological remissions were induced in 22 of the 48 patients (46%) with chronic-phase disease. Thirteen patients (27%) revealed partial haematological remission and another 13 no response to treatment. No complete remission could be induced, although minor or partial cytogenetic responses were seen in 16 patients (33%). Moreover, a bcr-abl reduction was detected on Southern blot analysis in two patients. In chronic-phase disease, results of treatment were influenced by elapsed time after diagnosis, extent of previous treatment and interferon dosage. No beneficial effects of interferon were detected in the six patients with acute-phase disease. Principal acute side effects were fever and flu-like symptoms at the beginning of the therapy, which usually subsided within 3–7 days. Chronic side effects, especially weakness and neuropathy, were less frequent but more severe and necessitated discontinuation of treatment in 10 patients. In summary, interferon alfa-2b seems to be an effective treatment in early chronic-phase CML. Long-term effects on the course of the disease, however, must be determined.

干扰素α -2b在急性期和慢性期慢性髓性白血病中的作用:54例患者的初始反应和长期结果
54例ph1阳性慢性髓性白血病(CML)患者(48例为慢性期,6例为急性期)接受α -2b干扰素皮下注射(s.c。起始剂量为每日400万单位(MU)/m2体表面积。与连续测定的白细胞计数同时减少,在达到缓解后给予最小有效剂量作为维持。48例慢性期疾病患者中有22例(46%)出现血液学缓解。13例患者(27%)显示部分血液学缓解,另外13例对治疗无反应。虽然16名患者(33%)出现了轻微或部分细胞遗传学反应,但无法诱导完全缓解。此外,在两名患者的Southern blot分析中检测到bcr-abl降低。在慢性期疾病中,治疗结果受诊断后时间、既往治疗程度和干扰素剂量的影响。6例急性期患者未发现干扰素的有益作用。主要急性副作用是治疗开始时发烧和流感样症状,通常在3-7天内消退。慢性副作用,特别是虚弱和神经病变,较少发生,但更严重,有10例患者需要停止治疗。综上所述,干扰素α -2b似乎是早期慢性粒细胞白血病的有效治疗方法。然而,对疾病病程的长期影响必须确定。
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