Teng G S, Zhang Y H, Wang Y, Du C X, Li Y Q, Hu N B, Xiang G P, Shao Z H, Bai J
Department of Hematology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Zhonghua Yi Xue Za Zhi. 2023 Dec 5;103(45):3645-3651. doi: 10.3760/cma.j.cn112137-20231007-00654.
To evaluate the efficacy and safety of pegylated interferon alpha-2b (PEG-IFN-α2b) in the treatment of myeloproliferative neoplasm (MPN). Thirty-four MPN patients receiving PEG-IFN-α2b treatment in the Second Hospital of Tianjin Medical University from August 2019 to October 2022 were prospectively included. Among the patients, 9 were male and 25 were female, and the median age [ (, )] was 57 (19, 78) years. Patients' clinical characteristics were collected and the follow-up was performed. As of January 30, 2023, the follow-up period [(, )] was 24 (16, 33) months. The efficacy, safety and changes in immune cell and cytokine levels after 12 and 24 months of treatment were analyzed. During the follow-up period, 4 patients dropped out, and the efficacy was evaluable in 30 patients. Following 12 and 24 months of treatment, the complete hematologic response (CHR) rates were 57.1% (16/28) and 75.0% (18/24), respectively. The complete molecular response (CMR)+partial molecular response (PMR) rates were 27.3% (6/22) and 55.0% (11/20), respectively. The bone marrow histopathological overall response rates (ORR) were 34.6% (9/26) and 47.6% (10/21), respectively. At 12 and 24 months of treatment, the proportions of CD8HLA-DRT cells, effector T cell subpopulations, CD56 natural killer (NK) cells, and plasmacytoid dendritic cells (pDC) were higher than the pre-treatment levels, while the proportion of CD56 NK cells was lower than the pre-treatment level (all <0.05). The levels of motif chemokine ligand 10 (CXCL10), tumor necrosis factor (TNF)-α and TNF-β in bone marrow all increased from those prior to treatment, while the levels of vascular endothelial growth factor (VEGF) and interleukin (IL-4) decreased from those prior to treatment (all <0.05). Among hematological adverse reactions, white blood cells decrease [47% (16/34)] was observed with high incidence. Among non-hematological adverse reactions, asthenia [44.1% (15/34)] and transaminases increase [32.3% (11/34)] were observed with high incidences. PEG-IFN-α2b has high hematologic, molecular, and bone marrow histopathological response rates in the treatment of MPN. It can reduce malignant clone loads and regulate the immune microenvironment and is safe and well tolerated overall.
评估聚乙二醇化干扰素α-2b（PEG-IFN-α2b）治疗骨髓增殖性肿瘤（MPN）的疗效和安全性。前瞻性纳入2019年8月至2022年10月在天津医科大学第二医院接受PEG-IFN-α2b治疗的34例MPN患者。患者中，男性9例，女性25例，中位年龄[（，）]为57（19，78）岁。收集患者的临床特征并进行随访。截至2023年1月30日，随访时间[（，）]为24（16，33）个月。分析治疗12个月和24个月后的疗效、安全性以及免疫细胞和细胞因子水平的变化。随访期间，4例患者退出，30例患者可评估疗效。治疗12个月和24个月后，完全血液学缓解（CHR）率分别为57.1%（16/28）和75.0%（18/24）。完全分子缓解（CMR）+部分分子缓解（PMR）率分别为27.3%（6/22）和55.0%（11/20）。骨髓组织病理学总体缓解率（ORR）分别为34.6%（9/26）和47.6%（10/21）。治疗12个月和24个月时，CD8HLA-DR+T细胞、效应T细胞亚群、CD56自然杀伤（NK）细胞和浆细胞样树突状细胞（pDC）的比例高于治疗前水平，而CD56NK细胞的比例低于治疗前水平（均P<0.05）。骨髓中趋化因子配体10（CXCL10）、肿瘤坏死因子（TNF）-α和TNF-β水平均较治疗前升高，而血管内皮生长因子（VEGF）和白细胞介素（IL-4）水平较治疗前降低（均P<0.05）。血液学不良反应中，白细胞减少[47%（16/34）]发生率较高。非血液学不良反应中，乏力[44.1%（15/34）]和转氨酶升高[32.3%（11/34）]发生率较高。PEG-IFN-α2b治疗MPN具有较高的血液学、分子学和骨髓组织病理学缓解率。它可降低恶性克隆负荷，调节免疫微环境，总体安全性好，耐受性佳。
