Pralle H, Zwingers T, Boedewadt S, Bross K, Dörken B, Gamm H, Ho A D, Parwaresch R M, Schmitz N, Papendick U
German Multicenter Study Group for Treatment of Hairy Cell Leukemia, Giessen.
Leukemia. 1987 Apr;1(4):337-40.
Our multicenter study on the treatment of hairy cell leukemia (HCL) started in December 1984 and the present data cover the time up to June 30, 1986. Ninety-seven patients were enrolled. For induction of response daily doses (6 micrograms) of low dose human recombinant alpha 2c-interferon (arg) was chosen. Further dose reduction (3 micrograms) was possible for patients who improved within the first 3-4 weeks. Patients with known risk factors started at lower doses (0.6 microgram daily). As infections are known to be the main cause of death in HCL, splenectomy was not mandatory before treatment. Thirty-nine patients received treatment with interferon. Nevertheless, infections remained the major cause of death in the study. The protocol did not prevent fatal infections in nine of the 34 splenectomized patients. The regimen proved safe for all but one of the nonsplenectomized patients. According to this experience, new criteria are needed for the choice of primary treatment in HCL. In our opinion splenectomy should become restricted to selected cases.
我们关于毛细胞白血病（HCL）治疗的多中心研究始于1984年12月，目前的数据涵盖截至1986年6月30日的时间段。共招募了97名患者。诱导缓解时选择每日低剂量（6微克）的重组人α2c干扰素（arg）。对于在最初3 - 4周内病情改善的患者，可进一步降低剂量（3微克）。有已知危险因素的患者起始剂量较低（每日0.6微克）。由于已知感染是HCL患者死亡的主要原因，治疗前并非必须进行脾切除术。39名患者接受了干扰素治疗。然而，感染仍是该研究中死亡的主要原因。该方案未能预防34例脾切除患者中的9例发生致命感染。除1例未行脾切除的患者外，该治疗方案对其他患者均证明是安全的。根据这一经验，需要新的标准来选择HCL的初始治疗方法。我们认为脾切除术应仅限于特定病例。
