Steegmann J L, Lavilla E, Somolinos N, Pérez-Sánchez M, Lamana M, Olmeda F, Cámara R, Arranz R, Ferro M T, Fernández-Rañada J M
Servicio de Hematología, Hospital de la Princesa, Madrid.
Sangre (Barc). 1992 Oct;37(5):375-81.
To evaluate the cytologic and cytogenetic response attained with interferon alpha-2a (IFN, Roferon*A) in patients with Ph '-positive chronic myelogenous leukaemia (CML) in the chronic phase.
A prospective study was carried out on 22 CML patients diagnosed in the Haematology Service at the Princesa Hospital in Madrid. The therapeutic regime consisted of two phases: A) Hydroxyurea was given until the white-cell count was reduced to 15-20 x 10(9)/L. B) Roferon*A was then given subcutaneously at a doses of 5 MU/m2 per day. The follow-up was performed weekly, and monthly once the leucocyte count had stabilized. The cytologic and cytogenetic response was assessed by bone marrow aspiration performed after 6, 9, 12 and 18 months. The toxicity was evaluated in accordance with the WHO recommendations.
The median follow-up is 263 days (21-930). Thirteen patients (65%) had initial complete haematological response and 3 (15%) had partial response. The mean time to achieve response was 42 days (0-321). In the last evaluation, 69% of the patients were in sustained haematological remission (53% complete and 16% partial) with median follow-up of 232 days (21-930). The cytogenetic response was evaluable in 13 patients (follow up > or = 6 months): three attained complete response (23%) and three others partial response (23%). The commonest untoward effects were hypertriglyceridaemia (100%) and myelosuppression (86%). Grade-III thrombocytopenia was seen in 19% of the patients and grade-III anaemia or leucopenia in 5%. No infectious or haemorrhagic complications have appeared. Therapy was discontinued in 3 patients (14%), two due to severe flu-like syndrome and one for parkinsonism after 809 days of treatment. At the moment of evaluation two patients had died, one in lymphoid blastic crisis on day 217 and the other in the immediate post-BMT period.
Treatment with interferon-alpha 2A is useful in the chronic phase of CML. An important number of responses can be attained, even in patients in the late chronic phase, and the toxicity seems acceptable.
评估α-2a干扰素（IFN，罗扰素*A）对慢性期Ph'阳性慢性粒细胞白血病（CML）患者的细胞学和细胞遗传学反应。
对马德里公主医院血液科诊断的22例CML患者进行前瞻性研究。治疗方案包括两个阶段：A）给予羟基脲直至白细胞计数降至15 - 20×10⁹/L。B）然后皮下注射罗扰素*A，剂量为每日5 MU/m²。每周进行随访，白细胞计数稳定后每月随访一次。在6、9、12和18个月后通过骨髓穿刺评估细胞学和细胞遗传学反应。根据世界卫生组织的建议评估毒性。
中位随访时间为263天（21 - 930天）。13例患者（65%）最初获得完全血液学缓解，3例（15%）获得部分缓解。达到缓解的平均时间为42天（0 - 321天）。在最后一次评估中，69%的患者处于持续血液学缓解状态（53%完全缓解，16%部分缓解），中位随访时间为232天（21 - 930天）。13例患者（随访≥6个月）可评估细胞遗传学反应：3例获得完全缓解（23%），另外3例获得部分缓解（23%）。最常见的不良反应是高甘油三酯血症（100%）和骨髓抑制（86%）。19%的患者出现III级血小板减少，5%的患者出现III级贫血或白细胞减少。未出现感染或出血并发症。3例患者（14%）停止治疗，2例因严重的流感样综合征，1例在治疗809天后因帕金森症停药。在评估时，2例患者死亡，1例在第217天发生淋巴细胞母细胞危象，另1例在骨髓移植后不久死亡。
α-2A干扰素治疗对CML慢性期有效。即使是晚期慢性期患者也能获得相当数量的反应，且毒性似乎可以接受。
