Klion Amy D, Law Melissa A, Noel Pierre, Kim Yae-Jean, Haverty Thomas P, Nutman Thomas B
Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
Blood. 2004 Apr 15;103(8):2939-41. doi: 10.1182/blood-2003-10-3620. Epub 2003 Dec 24.
Four patients with hypereosinophilic syndrome (HES) refractory to or intolerant of treatment with conventional therapy were treated with a single 1 mg/kg dose of SCH55700. SCH55700 was extremely well tolerated. Two of the 4 patients responded with a fall in eosinophil counts to within the normal range within 48 hours of receiving the drug, accompanied by marked improvement in clinical signs and symptoms. Response was not predicted by serum interleukin-5 (IL-5) levels or presence of the FIP1L1/PDGFRA mutation. Eosinophil counts remained suppressed for up to 12 weeks after treatment; however, exacerbation of symptoms and eosinophilia above baseline levels occurred as drug levels waned. Reinstitution of treatment with monthly SCH55700 led to decreased eosinophilia and symptomatic improvement, albeit to a lesser degree than that seen after the initial dose. These data suggest that anti-IL-5 therapy may be useful in the treatment of HES irrespective of the underlying etiology, although the observed rebound eosinophilia and attenuation of response require further study.
4例对传统治疗难治或不耐受的高嗜酸性粒细胞综合征（HES）患者接受了单次1mg/kg剂量的SCH55700治疗。SCH55700的耐受性非常好。4例患者中有2例在接受药物治疗后48小时内嗜酸性粒细胞计数降至正常范围，同时临床体征和症状有明显改善。血清白细胞介素-5（IL-5）水平或FIP1L1/PDGFRA突变的存在并不能预测疗效。治疗后嗜酸性粒细胞计数持续抑制长达12周；然而，随着药物水平下降，症状加重且嗜酸性粒细胞增多超过基线水平。每月使用SCH55700重新治疗导致嗜酸性粒细胞减少和症状改善，尽管程度低于初始剂量后的情况。这些数据表明，抗IL-5治疗可能对HES的治疗有用，无论其潜在病因如何，尽管观察到的嗜酸性粒细胞反弹和反应减弱需要进一步研究。
