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重组人干扰素α-2b治疗慢性粒细胞白血病:反应的剂量依赖性及中和性抗干扰素抗体的产生频率

Recombinant human interferon (IFN) alpha-2b in chronic myelogenous leukaemia: dose dependency of response and frequency of neutralizing anti-interferon antibodies.

作者信息

Freund M, von Wussow P, Diedrich H, Eisert R, Link H, Wilke H, Buchholz F, LeBlanc S, Fonatsch C, Deicher H

机构信息

Department of Haematology/Oncology, Hannover Medical School, Federal Republic of Germany.

出版信息

Br J Haematol. 1989 Jul;72(3):350-6. doi: 10.1111/j.1365-2141.1989.tb07715.x.

Abstract

Twenty-seven patients with Philadelphia chromosome positive chronic myelogenous leukaemia in the chronic phase were treated with low doses of recombinant interferon (IFN) alpha-2b. Ten patients entered a complete and six a partial haematologic remission with a median duration of 5.8 and 9.1 months respectively. Five minor cytogenetic responses were observed. These results are inferior compared to other studies with higher interferon-doses. Fever was an acute side effect after injection of IFN, limb pains and fatigue occurred protractedly. Haematologic side effects, nonspecific EEG changes, weight loss, and development of pulmonary infiltrates were observed in later periods of the treatment. Eight patients developed neutralizing anti-IFN antibodies after 4.2-20.4 months (median 12.8 months). Anti-IFN antibodies were associated with relapse or refractoriness to IFN treatment: five out of nine patients with rising WBC after initial fall had antibodies, while four did not. Two out of four patients with primary non-response had IFN-antibodies. These results may indicate a serious problem in the long-term treatment of CML with recombinant interferon.

摘要

27例处于慢性期的费城染色体阳性慢性粒细胞白血病患者接受了低剂量重组干扰素α-2b治疗。10例患者达到完全血液学缓解,6例部分缓解,完全缓解和部分缓解的中位持续时间分别为5.8个月和9.1个月。观察到5例微小细胞遗传学反应。与其他使用较高剂量干扰素的研究相比,这些结果较差。发热是注射干扰素后的急性副作用,肢体疼痛和疲劳持续出现。在治疗后期观察到血液学副作用、非特异性脑电图改变、体重减轻和肺部浸润。8例患者在4.2 - 20.4个月(中位时间12.8个月)后产生了中和性抗干扰素抗体。抗干扰素抗体与干扰素治疗的复发或难治性相关:9例白细胞最初下降后又升高的患者中有5例有抗体,4例没有。4例原发性无反应的患者中有2例有干扰素抗体。这些结果可能表明重组干扰素长期治疗慢性粒细胞白血病存在严重问题。

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