Suppressed thyroid-stimulating hormone secretion in patients treated with interleukin-2 and interferon-alpha 2b for metastatic melanoma.

H Mönig, A Hauschild, S Lange, U R Fölsch
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引用次数: 5

Abstract

Recent reports suggest that combined therapy with recombinant interleukin (IL)-2 and interferon (IFN) alpha 2b may result in autoimmune-induced thyroid dysfunction. We prospectively analyzed thyroid function for 6 weeks in two groups of patients with progressive metastatic melanoma treated according to two different protocols. In group I (n = 17) three treatment cycles were given, each with three weeks of subcutanous administration of rIL-2 and INF-alpha 2b at different doses. In group II (n = 13) the chemotherapeutic agent dacarbazine was given in addition. In group 1 three patients developed frank hyperthyroidism, which required antithyroid drug therapy in one case. Autoantibodies against thyroid microsomal antigen, thyroglobulin, and the thyroid-stimulating hormone (TSH) receptor were not significantly elevated in any of these patients. However, the remaining 14 patients showed a significant decrease in TSH after 6 weeks of treatment, from 1.8 +/- 0.9 to 0.7 +/- 0.7 microU/ml (P < 0.02). Thyroid hormones (triiodothyronine, thyroxine, free thyroxine) also increased during the observation time, but this did not parallel the drop in TSH levels. Only thyroxine increased above the upper limit of normal, while triiodothyronine and free thyroxine stayed within the normal range. In group II, 6 of 13 patients (46%) had a decreased TSH after 6 weeks of treatment. Mean TSH was 1.5 +/- 1.4 before and 0.8 +/- 0.6 microU/ml after 6 weeks and was totally suppressed in three cases. None of these patients showed ouvert hyperthyroidism. Hypothyroidism was not observed in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

白细胞介素-2和干扰素- α 2b治疗转移性黑色素瘤患者促甲状腺激素分泌的抑制
最近的报道表明,重组白细胞介素(IL)-2和干扰素(IFN) α 2b联合治疗可能导致自身免疫诱导的甲状腺功能障碍。我们前瞻性地分析了两组根据两种不同方案治疗的进展性转移性黑色素瘤患者6周的甲状腺功能。I组(n = 17)给予3个治疗周期,每个治疗周期分别皮下注射不同剂量的il -2和inf - α 2b 3周。II组(n = 13)在化疗药物达卡巴嗪的基础上给予治疗。在组1中,3例患者出现了明显的甲状腺功能亢进,其中1例需要抗甲状腺药物治疗。抗甲状腺微粒体抗原、甲状腺球蛋白和促甲状腺激素(TSH)受体的自身抗体在这些患者中均未显著升高。然而,其余14例患者在治疗6周后TSH明显下降,从1.8 +/- 0.9微u /ml降至0.7 +/- 0.7微u /ml (P < 0.02)。甲状腺激素(三碘甲状腺原氨酸、甲状腺素、游离甲状腺素)在观察期间也有所增加,但这与TSH水平的下降并不平行。只有甲状腺素高于正常上限,三碘甲状腺原氨酸和游离甲状腺素均在正常范围内。在II组,13名患者中有6名(46%)在治疗6周后TSH下降。治疗前平均TSH为1.5 +/- 1.4微u /ml, 6周后平均TSH为0.8 +/- 0.6微u /ml, 3例患者TSH完全抑制。这些患者均未表现出明显的甲亢。两组均未见甲状腺功能减退。(摘要删节250字)
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