Sacchi S, Kantarjian H, O'Brien S, Cohen P R, Pierce S, Talpaz M
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
J Clin Oncol. 1995 Sep;13(9):2401-7. doi: 10.1200/JCO.1995.13.9.2401.
Long-term treatment with interferon alfa (IFN alpha) can produce or exacerbate immune-mediated complications (IMC). The purpose of this study was to analyze the experience with IMC and unusual complications in patients with chronic myelogenous leukemia (CML) undergoing IFN alpha treatment.
The occurrence of IMC and unusual complications was evaluated in patients with Philadelphia chromosome (Ph)-positive CML.
Well-documented and clinically evident complications developed in 35 patients after a median of 14 months of IFN alpha treatment. These included 28 (5%) of 581 patients with Ph-positive CML treated with IFN alpha-containing regimens at M.D. Anderson Cancer Center (MDACC) and seven patients referred for opinion or problems who were on other studies. Hypothyroidism occurred in 11 patients (2%), immune-mediated hemolysis in seven (1%), and connective tissue diseases in 11 (2%). Other unusual occurrences included congestive heart failure (CHF; n = 4), porphyria cutanea tarda (PCT; n = 3), membranous glomerulonephritis (MGN; n = 1), and vitiligo (n = 1). IFN treatment was discontinued in 19 patients and the dose was reduced in five. Ten of 11 patients (91%) with immune-mediated hypothyroidism and eight of 11 (73%) with connective tissue diseases had some degree of cytogenetic response at the time of the event.
Although the frequency of IMC is low, patients treated with IFN alpha should be monitored for signs and symptoms of autoimmunity.
长期使用干扰素α（IFNα）治疗可引发或加重免疫介导的并发症（IMC）。本研究旨在分析接受IFNα治疗的慢性粒细胞白血病（CML）患者发生IMC及罕见并发症的情况。
对费城染色体（Ph）阳性CML患者的IMC及罕见并发症发生情况进行评估。
35例患者在接受IFNα治疗中位数14个月后出现了有充分记录且临床明显的并发症。其中包括在MD安德森癌症中心（MDACC）接受含IFNα方案治疗的581例Ph阳性CML患者中的28例（5%），以及7例因其他研究前来咨询或有问题的转诊患者。11例患者（2%）发生甲状腺功能减退，7例（1%）发生免疫介导的溶血，11例（2%）发生结缔组织病。其他罕见情况包括充血性心力衰竭（CHF；4例）、迟发性皮肤卟啉病（PCT；3例）、膜性肾小球肾炎（MGN；1例）和白癜风（1例）。19例患者停止IFN治疗，5例患者减少了剂量。11例免疫介导性甲状腺功能减退患者中有10例（91%）、11例结缔组织病患者中有8例（73%）在事件发生时出现了一定程度的细胞遗传学反应。
尽管IMC的发生率较低，但接受IFNα治疗的患者仍应监测自身免疫的体征和症状。
