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用重组干扰素-γ治疗慢性粒细胞白血病。

Therapy of chronic myelogenous leukemia with recombinant interferon-gamma.

作者信息

Kurzrock R, Talpaz M, Kantarjian H, Walters R, Saks S, Trujillo J M, Gutterman J U

机构信息

Department of Clinical Immunology, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.

出版信息

Blood. 1987 Oct;70(4):943-7.

PMID:3115339
Abstract

Recently, we reported that recombinant interferon-alpha (rIFN-alpha) can induce hematologic remissions and cytogenetic improvement in newly diagnosed Philadelphia (Ph)-positive chronic myelogenous leukemia (CML) patients. Although IFN-gamma is a structurally distinct molecule, this agent suppresses in vitro hematopoietic progenitor cells in a fashion similar to that of IFN-alpha. Therefore, we initiated a study of rIFN-gamma at doses of 0.25 to 0.5 mg/m2/d intramuscularly in patients with Ph-positive benign-phase CML. Twenty-six of 30 patients entered in the study were evaluable. Six patients have achieved a complete hematologic response; four, a partial hematologic response. The median follow-up period of patients who are in complete remission is 7.5 months (range, 5 to 12 months). No relapses have occurred among the complete responders. So far, five patients have had cytogenetic improvement with emergence of 5% to 45% diploid cells in the bone marrow. Fever and flulike symptoms were the most common side effects, with partial tolerance often developing after about 1 week. The majority of patients tolerated therapy with minimal change in performance status. In conclusion, rIFN-gamma has demonstrated clinical activity in CML. On the basis of these observations and the in vitro synergistic growth-inhibitory effects of IFN-alpha and IFN-gamma, we have started trials of combination IFN therapy in CML patients.

摘要

最近,我们报道重组干扰素-α(rIFN-α)可诱导新诊断的费城(Ph)阳性慢性粒细胞白血病(CML)患者出现血液学缓解和细胞遗传学改善。尽管干扰素-γ是一种结构不同的分子,但该药物以类似于干扰素-α的方式在体外抑制造血祖细胞。因此,我们启动了一项针对Ph阳性良性期CML患者的研究,采用剂量为0.25至0.5mg/m²/天的rIFN-γ进行肌肉注射。该研究纳入的30例患者中有26例可进行评估。6例患者实现了完全血液学缓解;4例为部分血液学缓解。完全缓解患者的中位随访期为7.5个月(范围为5至12个月)。完全缓解者中未发生复发。到目前为止,5例患者出现细胞遗传学改善,骨髓中出现5%至45%的二倍体细胞。发热和流感样症状是最常见的副作用,通常在约1周后会出现部分耐受性。大多数患者耐受治疗,其体能状态变化极小。总之,rIFN-γ在CML中已显示出临床活性。基于这些观察结果以及干扰素-α和干扰素-γ在体外的协同生长抑制作用,我们已开始对CML患者进行联合干扰素治疗试验。

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