Nagel-Hiemke M, Hiemke C, Kummer G, Moritz T, Müller H, Seeber S, Niederle N
Innere Klinik und Poliklinik (Tumorforschung), Universitätsklinikum Essen, Federal Republic of Germany.
Ann Hematol. 1992 Sep;65(3):116-20. doi: 10.1007/BF01695809.
During long-term interferon alpha-2b (IFN) therapy of Philadelphia chromosome-positive chronic myelogenous leukemia (CML) patients, short-term effects of tumor necrosis factor alpha (TNF) on peripheral leukocyte counts, as well as cortisol and corticotropin (ACTH) release were studied. TNF (40-160 micrograms/m2) was given as a 2-h infusion on 5 consecutive days every 3 weeks, in addition to s.c. daily IFN injections (4 mio U/m2), to four (two male/two female) patients, who had been treated for more than 8 months with IFN and additionally for 0-7 months with TNF. Leukocyte counts, cortisol, and ACTH were determined at 30-min intervals between 4 p.m. and midnight. Profiles were determined the day before and on day 1 of TNF therapy. Leukocyte numbers decreased 30 min after start of TNF administration and increased 30-60 min later with a rebound until the next TNF application. The increase of leukocyte counts was due mostly to neutrophil granulocytes. ACTH levels increased 30 min, cortisol 60 min, and leukocyte counts 90 min after start of TNF infusion. Metopirone, an inhibitor of cortisol synthesis given to one patient, suppressed the TNF-induced stimulation of cortisol secretion and subsequent increase of leukocyte counts, while ACTH blood levels were enhanced. It was concluded that leukocyte count increases after TNF/IFN administration might be related to TNF-evoked cortisol secretion.
在对费城染色体阳性慢性粒细胞白血病（CML）患者进行长期干扰素α-2b（IFN）治疗期间，研究了肿瘤坏死因子α（TNF）对外周白细胞计数以及皮质醇和促肾上腺皮质激素（ACTH）释放的短期影响。除了每天皮下注射IFN（400万U/m²）外，每3周连续5天给予4名患者（2名男性/2名女性）TNF（40 - 160μg/m²），输注2小时，这些患者接受IFN治疗超过8个月，另外接受TNF治疗0 - 7个月。在下午4点至午夜之间每隔30分钟测定白细胞计数、皮质醇和ACTH。在TNF治疗前一天和第1天测定数据曲线。TNF给药开始后30分钟白细胞数量减少，30 - 60分钟后增加并出现反弹，直至下一次TNF应用。白细胞计数增加主要是由于中性粒细胞。TNF输注开始后30分钟ACTH水平升高，60分钟皮质醇升高，90分钟白细胞计数升高。给予一名患者的皮质醇合成抑制剂美替拉酮抑制了TNF诱导的皮质醇分泌刺激以及随后白细胞计数的增加，而ACTH血液水平升高。得出的结论是，TNF/IFN给药后白细胞计数增加可能与TNF诱发的皮质醇分泌有关。
