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用干扰素治疗白血病和淋巴瘤:I. 人β干扰素治疗骨髓瘤的试验

[Treatment of leukemias and lymphomas with interferons: I. Trial of myeloma therapy with human beta-interferon].

作者信息

Misset J L, Mathé G, Gastiaburu J, Goutner A, Dorval T, Gouveia J, Hayat M, Jasmin C, Schwarzenburg L, Machover D, Ribaud P, De Vassal F, Horosezewicz J S

出版信息

Biomed Pharmacother. 1982 Jan;36(1):55-9.

PMID:6181822
Abstract

Eighteen patients with malignant gammapathies (16 with myeloma and 2 with Waldenström's disease) for a short time because in a phase II-I trial were treated with human (IF beta) given i. v. 6 X 10(6) units weekly (7 patients) or 3 X 10(6) units twice weekly (11 patients) during at least 3 months if tolerated. Treatment was discontinued because of side-effects in three patients. Reduction of the M component of at least 25% from the initial value was obtained in 3 patients. In one case, was also observed in disappearance of the urinary Bence-Jones protein, in 4 cases a significant reduction of bone marrow infiltration by plasma cells and, in 5 cases, major alleviation or disappearance of bone pain. Length of treatment seems an important factor for activity. Immune monitoring with currently available tests, mainly NK cell activity, yielded no correlation with therapeutic effect in these patients. This very preliminary study demonstrates the effect of fibroblastic interferon in myeloma, but further studies are mandatory to determine the population of patients likely to benefit from treatment, the best modalities, possible special indication, dose schedule and duration of treatment. Interferon, however, already appears in this population of patients as giving results similar to those of single agent chemotherapy. As it is not myelosuppressive, it could be indicated in that frequent situation of advanced myeloma with bone marrow failure contra-indicating combination chemotherapy.

摘要

18例恶性γ球蛋白病患者(16例骨髓瘤患者和2例华氏巨球蛋白血症患者)参加了一项II - I期试验,短期内接受静脉注射人(IFβ)治疗。如果耐受,每周给予6×10⁶单位(7例患者)或每周两次给予3×10⁶单位(11例患者),持续至少3个月。3例患者因副作用停止治疗。3例患者的M成分较初始值降低了至少25%。1例患者尿本周氏蛋白消失,4例患者浆细胞骨髓浸润显著减少,5例患者骨痛明显减轻或消失。治疗时长似乎是影响疗效的一个重要因素。目前可用检测方法进行的免疫监测,主要是NK细胞活性监测,在这些患者中与治疗效果无相关性。这项非常初步的研究证明了成纤维细胞干扰素对骨髓瘤的疗效,但需要进一步研究以确定可能从治疗中获益的患者群体、最佳治疗方式、可能的特殊适应证、剂量方案和治疗持续时间。然而,干扰素在这类患者中已显示出与单药化疗相似的效果。由于它不具有骨髓抑制作用,对于晚期骨髓瘤伴骨髓衰竭而禁忌联合化疗的常见情况,它可能是一种选择。

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