Kchour Ghada, Makhoul Nadine J, Mahmoudi Mahmoud, Kooshyar Mohamad-Mehdi, Shirdel Abbas, Rastin Maryam, Rafatpanah Houshang, Tarhini Mahdi, Zalloua Pierre A, Hermine Olivier, Farid Reza, Bazarbachi Ali
Immunology Research Centre, Bu-Ali Research institute, Mashhad University of Medical Sciences, Iran.
Leuk Lymphoma. 2007 Feb;48(2):330-6. doi: 10.1080/10428190601071717.
Human T-cell lymphotropic virus type I (HTLV-I) associated adult T-cell leukemia/lymphoma (ATLL) is endemic in southern Japan, the Caribbean, intertropical Africa, and Brazil. Recently north east Iran, particularly the region of Mashhad, has been recognized as a new endemic region. ATLL is an aggressive T-cell lymphoproliferative disorder. Patients with ATLL have high plasma levels of VEGF that induce angiogenesis. Prognosis of ATLL remains poor because of immunosuppression and intrinsic resistance to chemotherapy. Important advances in the treatment of ATLL were reported with the combination of zidovudine (AZT) and interferon-alpha. We investigated the effect of AZT/IFN treatment on vascular endothelium growth factor (VEGF) plasma levels and HTLV-I proviral load in ATLL patients from the region of Mashhad. We confirmed that AZT/IFN treatment induces a high response rate and prolonged survival with minimal side effects. We also confirmed that VEGF plasma levels and HTLV-I proviral load are higher in ATLL patients than in asymptomatic carriers. We finally showed that AZT/IFN treatment reduced both HTLV-I proviral load and importantly VEGF plasma levels, suggesting a potential antiangiogenic effect of this therapy. These results provide further evidence for the efficacy and the mechanism of action of AZT/IFN therapy for ATLL in a developing country.
人类嗜T细胞病毒I型（HTLV-I）相关的成人T细胞白血病/淋巴瘤（ATLL）在日本南部、加勒比地区、热带非洲和巴西呈地方流行性。最近，伊朗东北部，特别是马什哈德地区，已被确认为一个新的地方流行区。ATLL是一种侵袭性T细胞淋巴增殖性疾病。ATLL患者血浆中血管内皮生长因子（VEGF）水平较高，可诱导血管生成。由于免疫抑制和对化疗的固有抗性，ATLL的预后仍然很差。据报道，齐多夫定（AZT）和α干扰素联合使用在ATLL治疗方面取得了重要进展。我们研究了AZT/IFN治疗对来自马什哈德地区的ATLL患者血浆中血管内皮生长因子（VEGF）水平和HTLV-I前病毒载量的影响。我们证实，AZT/IFN治疗诱导的缓解率高，生存期延长，且副作用最小。我们还证实，ATLL患者的VEGF血浆水平和HTLV-I前病毒载量高于无症状携带者。我们最终表明，AZT/IFN治疗降低了HTLV-I前病毒载量，重要的是还降低了VEGF血浆水平，提示该疗法具有潜在的抗血管生成作用。这些结果为AZT/IFN疗法在一个发展中国家治疗ATLL的疗效和作用机制提供了进一步的证据。
