Iguchi Tomotaka, Nishimaki Jiroh, Kawakubo Ken, Shimamoto Takashi, Iwase Osamu, Suzuki Akitaka, Kuriyama Yuzuru, Ito Yoshikazu, Tauchi Tetsuzo, Yaguchi Makoto, Miyazawa Keisuke, Kimura Yukihiko, Ohyashiki Kazuma
First Dept. of Internal Medicine, Tokyo Medical University.
Gan To Kagaku Ryoho. 2003 Nov;30(12):1911-6.
The development of various kinds of autoimmune disease as a result of interferon-alpha (IFN-alpha) therapy has been reported among chronic myeloproliferative disorders(CMPD) including chronic myeloid leukemia(CML). Therefore, we investigated the frequency of autoimmune disorders in 33 patients with hematopoietic diseases treated with IFN-alpha in our department. Thirty-three patients (12 females, 21 males) included cases of CML (n = 23), essential thrombocythemia (ET) (n = 1), multiple myeloma (n = 8), and hypereosinophilic syndrome (HES) (n = 1). Autoantibodies (ANA, dsDNA, and RAPA), thyroid grand functions, and coagulant functions were examined. Twenty-five out of 33 patients were treated with natural IFN-alpha, and 8 patients were treated with recombinant IFN-alpha 2b (rIFN alpha-2b). Three patients were treated with IFN and anticancer agents. Antinuclear antibodies were detected in 2 of 33 patients. RAPA and anti-thyroglobulin antibody became positive in 3 and 4 patients, respectively. Ten patients showed low serum levels of either free T3 and/or free T4. However, none of them showed any clinical symptoms for developing autoimmune diseases. In addition, circulating anticoagulant antibodies were detected in 3 of 23 patients with CML treated with rIFN alpha-2b, but in no cases treated with natural IFN-alpha. Although none of the patients developed autoimmune diseases, we concluded that patients receiving IFN therapy should be carefully monitored for clinical signs and symptoms of autoimmune disorders.
据报道，在包括慢性粒细胞白血病（CML）在内的慢性骨髓增殖性疾病（CMPD）中，由于α干扰素（IFN-α）治疗导致了各种自身免疫性疾病的发生。因此，我们调查了在我院接受IFN-α治疗的33例血液病患者中自身免疫性疾病的发生频率。33例患者（12例女性，21例男性）包括CML患者（n = 23）、原发性血小板增多症（ET）患者（n = 1）、多发性骨髓瘤患者（n = 8）和高嗜酸性粒细胞综合征（HES）患者（n = 1）。检测了自身抗体（抗核抗体、双链DNA抗体和类风湿因子）、甲状腺功能和凝血功能。33例患者中有25例接受天然IFN-α治疗，8例患者接受重组IFN-α 2b（rIFNα-2b）治疗。3例患者同时接受IFN和抗癌药物治疗。33例患者中有2例检测到抗核抗体。3例和4例患者的类风湿因子和抗甲状腺球蛋白抗体分别呈阳性。10例患者的游离T3和/或游离T4血清水平较低。然而，他们均未表现出任何自身免疫性疾病的临床症状。此外，在23例接受rIFNα-2b治疗的CML患者中有3例检测到循环抗凝抗体，但接受天然IFN-α治疗的患者均未检测到。尽管所有患者均未发生自身免疫性疾病，但我们得出结论，接受IFN治疗的患者应密切监测自身免疫性疾病的临床体征和症状。
