Seewann H L, Zikulnig R, Gallhofer G, Schmid C
III Department of Medicine, County Hospital, Graz, Austria.
Eur J Cancer. 1991;27 Suppl 4:S58-62; discussion S62-3. doi: 10.1007/978-3-642-75510-1_71.
Thirty-six patients with chronic myeloproliferative disorders (CMPD) with thrombocytosis (essential thrombocythaemia 19 patients, chronic megakaryocytic granulocytic myelosis five, polycythaemia vera six, chronic myelogenous leukaemia six) were treated with interferon alfa-2b to reduce the platelet count. The pre-treatment platelet count was in the range 450-700 x 10(9)/L in eight patients, 700-1000 x 10(9)/L in eight and above 1000 x 10(9)/L in 20. In the induction phase of treatment 22 patients were treated with interferon alfa-2b 3 million units (MU) daily subcutaneously for 2 months or until the platelet count returned to normal, if earlier. Fourteen patients received 5 MU interferon alfa-2b daily in the same way. In the maintenance phase the doses were reduced to 3 MU and 5 MU thrice weekly, respectively. Complete response (CR), defined as a reduction of platelet count to below 450 x 10(9)/L, was achieved in 78% of patients (within 2 months of induction in 64%). The platelet depleting effect was dose dependent: CR in 2 months in 52% on 3 MU interferon alfa-2b versus 75% on 5 MU. Reduction of interferon dose was followed by an increase in platelet count in 39% of patients. The white cell count fell by 50% in Philadelphia-negative CMPD. Side effects were common, though generally mild, but led to withdrawal of treatment in six patients. Three patients suffered cerebrovascular events during treatment and one shortly thereafter.
36例慢性骨髓增殖性疾病（CMPD）伴血小板增多症患者（原发性血小板增多症19例、慢性巨核细胞粒细胞性骨髓增生症5例、真性红细胞增多症6例、慢性粒细胞白血病6例）接受了α-2b干扰素治疗以降低血小板计数。8例患者治疗前血小板计数在450 - 700×10⁹/L之间，8例在700 - 1000×10⁹/L之间，20例高于1000×10⁹/L。在治疗诱导期，22例患者皮下注射α-2b干扰素300万单位（MU），每日1次，共2个月，或血小板计数恢复正常（若更早恢复正常则提前结束）。14例患者以同样方式接受5MUα-2b干扰素每日治疗。在维持期，剂量分别减至3MU和5MU，每周3次。完全缓解（CR）定义为血小板计数降至450×10⁹/L以下，78%的患者达到完全缓解（64%在诱导期2个月内达到）。血小板减少效应呈剂量依赖性：接受3MUα-2b干扰素治疗的患者中52%在2个月内达到CR，而接受5MU治疗的患者中这一比例为75%。39%的患者在减少干扰素剂量后血小板计数升高。费城染色体阴性的CMPD患者白细胞计数下降50%。副作用常见，虽一般较轻，但6例患者因此停止治疗。3例患者在治疗期间发生脑血管事件，1例在治疗后不久发生。
