Service de Médecine Interne, IUCT Oncopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse.
Département d'Hématologie, Institut Gustave Roussy, Université Paris Sud, Villejuif.
Rheumatology (Oxford). 2021 Jul 1;60(7):3404-3408. doi: 10.1093/rheumatology/keaa696.
Systemic inflammatory and autoimmune diseases can be associated with myelodysplastic syndromes. Current treatments (steroids, immunosuppressive agents, biologics) are unsatisfactory because of their low response rate, dependence or adverse events. We aimed at evaluating the effects of low doses of IL-2 (ld-IL2) as a regulatory T-cell inducer in this context.
We treated three patients with ld-IL2 with myelodysplastic syndromes and an associated dysimmune disorder (polymyalgia rheumatic, relapsing polychondritis associated with Sweet's syndrome and vasculitis with cutaneous and joint involvement, respectively). All three patients were dependent on steroids and refractory to biologics or azacitidine. They received doses of 1-1.5 million units of proleukin/day during 5 days and then every fortnight.
The treatment led to a clinical improvement and steroid sparing in 2/3 patients with no serious adverse events, and no progression of the disease.
Our results support the investigation of ld-IL2 in MDS associated with immune disorders in controlled clinical studies.
系统性炎症和自身免疫性疾病可能与骨髓增生异常综合征相关。由于其低反应率、依赖性或不良反应，目前的治疗方法（类固醇、免疫抑制剂、生物制剂）并不令人满意。我们旨在评估低剂量白细胞介素 2 (ld-IL2)作为调节性 T 细胞诱导剂在这种情况下的效果。
我们用 ld-IL2 治疗了 3 名患有骨髓增生异常综合征和相关免疫失调疾病的患者（分别为风湿性多肌痛、与 Sweet 综合征相关的复发性多软骨炎和伴有皮肤和关节受累的血管炎）。这 3 名患者均依赖于类固醇，且对生物制剂或阿扎胞苷治疗无效。他们接受了为期 5 天，每天 100 万至 150 万单位普乐可复的治疗，然后每两周进行一次。
该治疗在 2/3 的患者中导致了临床改善和类固醇节约，且无严重不良事件，疾病也没有进展。
我们的结果支持在对照临床试验中研究 ld-IL2 在与免疫紊乱相关的 MDS 中的作用。
