低剂量α干扰素治疗慢性髓性白血病的细胞遗传学和断点簇区(bcr)变化

Robin Aitchison , Ellen McSweeney , Les Butler , Leanne Weidemann , Adrian C. Newland
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引用次数: 2

摘要

人们对α干扰素在慢性髓性白血病(CML)治疗中的作用一直很感兴趣,因为它是一种有效的疾病控制药物,而且在很大比例的病例中可以看到细胞遗传学的改善。我们已将23例慢性CML患者纳入一项研究,使用标准口服化疗联合干扰素α -2b (IFN) 300万单位(MU)皮下注射,每周3次。所有患者均为100% ph1阳性,2223例患者在IFN治疗开始时可检测到bcr重排。干扰素治疗前慢性期的中位持续时间为18个月(范围1-56个月)。2223例患者口服IFN化疗,试图达到血液学完全缓解。治疗耐受性良好;7例患者需要减少干扰素剂量:3例骨髓抑制,1例免疫性血小板减少,3例肝功能检查异常。IFN治疗的平均持续时间为17个月(范围6-38个月)。23例患者中有6例(26%)的ph1阳性中期比例下降(6例平均= 56% ph1阳性,范围7-97%)。在所有表现出细胞遗传学反应的患者中,bcr仍保持重排。自开始干扰素治疗以来的中位随访时间为31个月(21-79个月),自诊断以来的中位随访时间为43个月(29-82个月)。4名患者已进入母细胞转化(3名髓细胞和1名淋巴细胞),4名患者死亡,3名患者发生母细胞转化,1名患者发生骨髓纤维化和骨髓衰竭。这些结果表明,相对低剂量IFN (9 MU/周)治疗耐受性良好,并且在相当比例的病例中产生核型改善。需要更长的随访来评估组的生存和患者生存与细胞遗传学反应的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cytogenetic and breakpoint cluster region (bcr) changes in chronic myelogenous leukaemia treated with low-dose alpha interferon

THERE is continuing interest in the role of alpha interferon in the treatment of chronic myelogenous leukaemia (CML), both because it is an effective agent for disease control and because cytogenetic improvement is seen in a significant proportion of cases. We have entered 23 patients with chronic phase CML into a study using standard oral chemotherapy in conjunction with interferon alfa-2b (IFN) 3 million units (MU) subcutaneously three times a week. All patients were 100% Ph1-positive and 2223 had a detectable bcr rearrangement at the start of IFN therapy. The median duration of chronic phase before IFN treatment was 18 months (range 1–56 months). Oral chemotherapy was given with IFN in 2223 patients to try to achieve complete haematological remission. Treatment was well tolerated; IFN dosage reduction was necessary in seven patients: three with myelosuppression, one with immune thrombocytopenia and three with abnormal liver function tests. The mean duration of IFN treatment is 17 months (range 6–38 months). There has been a reduction in the proportion of Ph1-positive metaphases in six (26%) of the 23 patients (mean of six = 56% Ph1-positive, range 7–97%). The bcr remained rearranged in all those showing a cytogenetic response. Median duration of follow up is now 31 months since the start of interferon treatment (range 21–79 months) and 43 months since diagnosis (range 29–82 months). Four patients have gone into blast transformation (three myeloid and one lymphoid) and four have died, three following blast transformation and one with myelofibrosis and marrow failure. These results suggest that treatment with comparatively low-dose IFN (9 MU/week) is well tolerated and produces karyotypic improvement in a significant proportion of cases. Longer follow-up will be required to assess the group's survival and the relationship of patient survival to cytogenetic response.

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