Treatment of thrombocytosis in chronic myeloproliferative disorders with interferon alfa-2b

Heinz L. Seewann , Ronald Zikulnig , Gertraud Gallhofer , Christine Schmid
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引用次数: 14

Abstract

Thirty-six patients with chronic myeloproliferative disorders (CMPD) with thrombocytosis (essential thrombocythaemia 19 patients, chronic megakaryocytic granulocytic myelosis five, polycythaemia vera six, chronic myelogenous leukaemia six) were treated with interferon alfa-2b to reduce the platelet count. The pre-treatment platelet count was in the range 450–700 × 109/L in eight patients, 700–1000 × 109/L in eight and above 1000 × 109/L in 20. In the induction phase of treatment 22 patients were treated with interferon alfa-2b 3 million units (MU) daily subcutaneously for 2 months or until the platelet count returned to normal, if earlier. Fourteen patients received 5 MU interferon alfa-2b daily in the same way. In the maintenance phase the doses were reduced to 3 MU and 5 MU thrice weekly, respectively. Complete response (CR), defined as a reduction of platelet count to below 450 × 109/L, was achieved in 78% of patients (within 2 months of induction in 64%). The platelet depleting effect was dose dependent: CR in 2 months in 52% on 3 MU interferon alfa-2b versus 75% on 5 MU. Reduction of interferon dose was followed by an increase in platelet count in 39% of patients. The white cell count fell by 50% in Philadelphia-negative CMPD. Side effects were common, though generally mild, but led to withdrawal of treatment in six patients. Three patients suffered cerebrovascular events during treatment and one shortly thereafter.

干扰素α -2b治疗慢性骨髓增生性疾病的血小板增多症
对36例合并血小板增多的慢性骨髓增生疾病(CMPD)患者(原发性血小板增多症19例,慢性巨核粒细胞性骨髓增生症5例,真性红细胞增多症6例,慢性粒细胞性白血病6例)进行干扰素α -2b治疗,以降低血小板计数。治疗前血小板计数450 ~ 700 × 109/L 8例,700 ~ 1000 × 109/L 8例,1000 × 109/L以上20例。在诱导治疗阶段,22例患者每天皮下注射300万单位(MU)干扰素α -2b治疗2个月或直到血小板计数恢复正常(如果更早)。14例患者每日以相同方式给予5 μ干扰素α -2b。在维持期,剂量分别减少到3 MU和5 MU,每周3次。78%的患者达到完全缓解(CR),定义为血小板计数降至450 × 109/L以下(64%的患者在诱导后2个月内)。血小板消耗作用是剂量依赖性的:干扰素α -2b组2个月CR为3mu组52%,而干扰素α -2b组为5mu组75%。干扰素剂量减少后,39%的患者血小板计数增加。费城CMPD阴性患者白细胞计数下降50%。副作用是常见的,虽然通常轻微,但导致6名患者退出治疗。3名患者在治疗期间发生脑血管事件,1名患者在治疗后不久发生脑血管事件。
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