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[干扰素治疗白血病和淋巴瘤:II. 人α干扰素治疗慢性淋巴细胞白血病的II期试验性治疗]

[Treatment of leukemias and lymphomas by interferons: II. Phase II of the trial treatment of chronic lymphoid leukemia by human interferon alpha+].

作者信息

Misset J L, Mathé G, Gastiaburu J, Goutner A, Dorval T, Gouveia J, Schwarzenberg L, Machover D, Ribaud P, de Vassal F

出版信息

Biomed Pharmacother. 1982 Mar;36(2):112-6.

PMID:7126777
Abstract

Nine patients with chronic lymphoid leukemia (CLL) were treated with subcutaneous human (leukocyte) interferon alpha (IF alpha). In the first part of the study, 7 patients received intermittent 10 day courses, with free intervals of 10 to 15 days and with a rising dose in the same patient from cycle to cycle, if tolerance permits, from 1.5 to 6 X 10(6) units daily. As we observed a decrease of peripheral lymphocytosis with low doses, and as high doses gave more side-effect in the second part of the study, 4 patients (including two who had previously received intermittent courses) were treated for three months or more at a dose of 1.5 X 10(6) units daily. Tumor mass reduction was seen in only three patients, but significant decrease in peripheral lymphocytosis was seen in 7 patients sustained in the continuous treatment group with relapse at treatment discontinuation in one patient and despite continuation in another. Immune monitoring with currently available T, B, NK and macrophage tests, showed, in this population of patients, a very good correlation between NK cell activity and clinical response. Further studies are warranted to determine the best modalities of treatment as well as the population of patients likely to benefit from it, and the possible special respective indications of IF, and of the other treatments of CLL. One can already consider as a reasonable indication CLL presentations with myeloid insufficiency as IF is not myelotoxic, contrary to chemotherapy.

摘要

9例慢性淋巴细胞白血病(CLL)患者接受皮下注射人(白细胞)干扰素α(IFα)治疗。在研究的第一部分,7例患者接受为期10天的间歇疗程,间歇期为10至15天,且同一患者在每个周期中剂量递增(如果耐受允许),从每日1.5×10⁶单位增至6×10⁶单位。由于我们观察到低剂量时外周淋巴细胞增多症有所减少,且在研究的第二部分高剂量会产生更多副作用,所以4例患者(包括2例先前接受过间歇疗程的患者)以每日1.5×10⁶单位的剂量治疗了三个月或更长时间。仅3例患者出现肿瘤肿块缩小,但7例患者外周淋巴细胞增多症显著减少,持续治疗组中有1例患者在治疗中断时复发,另1例患者尽管继续治疗仍复发。用目前可用的T、B、NK和巨噬细胞检测进行免疫监测显示,在这群患者中,NK细胞活性与临床反应之间有很好的相关性。有必要进一步研究以确定最佳治疗方式以及可能从治疗中获益的患者群体,以及IF和CLL其他治疗方法可能的特殊各自适应症。鉴于IF不像化疗那样具有骨髓毒性,对于伴有骨髓功能不全的CLL表现,已经可以将其视为一种合理的适应症。

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