Sao H, Kato C, Kitaori K, Adachi T, Yano K, Kobayashi M, Kojima H, Tanimoto M, Hirabayashi N, Minami S, Yamada H, Morishita G Y, Morishima Y, Kodera Y
Department of Hematology, Meitetsu Hospital, Nagoya, Japan.
Int J Hematol. 2000 Aug;72(2):237-42.
The purpose of this study was to assess the efficacy and safety of interferon (IFN) treatment in patients with a relapse of chronic myelogenous leukemia (CML) after bone marrow transplantation in Japan. Accordingly, we retrospectively analyzed the results obtained from 8 patients treated with IFN by the Nagoya Blood and Marrow Transplantation Group. One of 3 patients with hematologic relapse and all 5 patients with cytogenetic relapse achieved complete cytogenetic response (CCR). The median time to achieve CCR was 8 months (range, 3-16 months). One patient relapsed 9 months after starting IFN and died of blast crisis. CCR was maintained for a median duration of 47 months (range, 9-79 months) in the remaining 5 patients. The median duration of survival of these 5 patients after starting IFN was 58 months (range, 12-89 months). At the time of this report, 2 patients who did not attain CCR have survived for 81 months and 142 months after starting IFN, respectively. During IFN treatment, 1 patient showed a transient deterioration of chronic graft-versus-host disease, and no treatment-related deaths were observed. These results suggest that treatment with IFN for CML patients who relapse after bone marrow transplantation is effective and safe. A prospective study to compare IFN with donor lymphocyte infusion is necessary to establish the optimal strategy for the treatment of CML patients who relapse after bone marrow transplantation.
本研究的目的是评估在日本接受骨髓移植后慢性粒细胞白血病（CML）复发患者中干扰素（IFN）治疗的疗效和安全性。因此，我们回顾性分析了名古屋血液和骨髓移植组对8例接受IFN治疗患者的结果。3例血液学复发患者中的1例以及所有5例细胞遗传学复发患者均获得了完全细胞遗传学缓解（CCR）。达到CCR的中位时间为8个月（范围3 - 16个月）。1例患者在开始IFN治疗9个月后复发，并死于原始细胞危象。其余5例患者的CCR维持中位持续时间为47个月（范围9 - 79个月）。这5例患者开始IFN治疗后的中位生存时间为58个月（范围12 - 89个月）。在本报告时，2例未达到CCR的患者在开始IFN治疗后分别存活了81个月和142个月。在IFN治疗期间，1例患者慢性移植物抗宿主病出现短暂恶化，未观察到与治疗相关的死亡。这些结果表明，对于骨髓移植后复发的CML患者，IFN治疗是有效且安全的。有必要进行一项前瞻性研究，比较IFN与供体淋巴细胞输注，以确立骨髓移植后复发的CML患者的最佳治疗策略。
