Wandl U B, Opalka B, Kloke O, Nagel-Hiemke M, Moritz T, Niederle N
Department of Internal Medicine, University of Essen, Germany.
Semin Oncol. 1992 Apr;19(2 Suppl 4):88-94.
In vitro data suggest a synergistic antiproliferative effect of different cytokines. In four clinical studies chronic myelogenous leukemia (CML) patients were treated with interferon (IFN)-alpha alone or IFN-alpha combined with either low-dose IFN-gamma or tumor necrosis factor (TNF)-alpha. The best response was achieved in previously untreated patients with good prognostic factors and highest tolerable IFN dose for maintenance treatment. Breakpoint localization within the major breakpoint cluster region did not correlate with response to IFN. In a randomized study of IFN-alpha versus IFN-alpha combined with IFN-gamma, no differences in response rates were observed. Patients with primary or secondary resistance to these treatment modalities received a combination therapy with IFN-alpha and TNF-alpha. In these patients, a decrease in leukocyte counts was noted, but no cytogenetic improvement occurred.
体外数据表明不同细胞因子具有协同抗增殖作用。在四项临床研究中，慢性粒细胞白血病（CML）患者单独接受α干扰素（IFN）治疗，或接受α干扰素与低剂量γ干扰素或肿瘤坏死因子（TNF）-α联合治疗。对预后良好且维持治疗可耐受的最高IFN剂量的初治患者疗效最佳。主要断裂点簇区域内的断点定位与对IFN的反应无关。在一项α干扰素与α干扰素联合γ干扰素的随机研究中，未观察到反应率的差异。对这些治疗方式产生原发性或继发性耐药的患者接受了α干扰素和TNF-α联合治疗。在这些患者中，白细胞计数有所下降，但细胞遗传学未得到改善。
