Nielsen H, Nielsen J L, Karle H
Department of Internal Medicine, University Hospital of Hvidovre, Denmark.
Eur J Haematol. 1992 Aug;49(2):67-70. doi: 10.1111/j.1600-0609.1992.tb00033.x.
Eleven previously untreated patients with chronic-phase Philadelphia-chromosome-positive chronic myelogenous leukemia were treated with cytotoxic chemotherapy followed by interferon-alfa-2b (IFN-alpha) maintenance. Initial chemotherapy consisted of three cycles of mitoxantrone 10 mg/m2 on day 1 and 2, and cytarabine 100 mg/m2 daily for 5 d. Complete hematological response was obtained in 9 (82%) patients with moderately associated toxicity. However, cytogenetic responses after three cycles were poor and transient (1 partial suppression and 2 minor suppression of Ph chromosome). Maintenance therapy with IFN-alpha was started in 10 patients at 5 x 10(6) U/m2 daily with dose reduction if hematologic toxicity or severe side-effects occurred. Of 9 evaluable patients treated for more than 3 months, 6 patients maintained a complete hematological response, whereas 1 patient remained in partial remission and 2 patients showed progressive disease. Cytogenetic evaluation showed partial suppression of Ph chromosome in 1 patient, whereas 1 patient had a minor response and 5 patients had no change or evolution of new chromosome abnormalities. As the results are not superior to IFN-alpha treatment alone, it is concluded that initial cytoreduction by mitoxantrone and cytarabine has no impact on the outcome of therapy in CML.
11例既往未接受过治疗的慢性期费城染色体阳性慢性粒细胞白血病患者接受了细胞毒性化疗，随后采用α-2b干扰素（IFN-α）维持治疗。初始化疗包括3个周期，第1天和第2天使用米托蒽醌10 mg/m²，阿糖胞苷100 mg/m²每日1次，共5天。9例（82%）患者获得完全血液学缓解，毒性反应中度相关。然而，3个周期后的细胞遗传学反应较差且短暂（1例部分抑制，2例费城染色体轻微抑制）。10例患者开始使用IFN-α维持治疗，剂量为5×10⁶ U/m²每日1次，若出现血液学毒性或严重副作用则减量。在9例接受治疗超过3个月的可评估患者中，6例患者维持完全血液学缓解，1例患者仍处于部分缓解，2例患者疾病进展。细胞遗传学评估显示，1例患者费城染色体部分抑制，1例患者有轻微反应，5例患者无变化或出现新的染色体异常。由于结果并不优于单独使用IFN-α治疗，得出结论：米托蒽醌和阿糖胞苷进行初始细胞减灭术对慢性粒细胞白血病的治疗结局无影响。
