Vallisa D, Cavanna L, Berté R, Merli F, Ghisoni F, Buscarini L
Divisione Medica, Servizio di Ematologia, Ospedale Civile, Piacenza, Italia.
Acta Haematol. 1995;93(1):31-5. doi: 10.1159/000204086.
The widespread use of alpha-interferon (IFN-alpha) therapy in different diseases draws attention to its side effects, such as autoimmune-related diseases, especially thyroid autoimmune dysfunctions. Data about hepatitis and nonhematologic neoplasia are available, while data about hematologic malignancies are fragmentary. We studied the incidence of autoimmune-related disturbances and thyroid dysfunctions in 54 consecutive patients suffering from hematologic malignancies, treated with recombinant human IFN-alpha for a mean time of 15.9 +/- 8.9 months. Our results minimize the incidence of autoimmune dysfunctions in hematologic malignancies as side effects of IFN-alpha therapy. We registered the appearance of autoantibodies in only 3 females (5% of total): 2 patients (1 affected with essential thrombocythemia and one with multiple myeloma) presented antithyroglobulin antibodies with no clinical symptoms; 1 patient, affected with essential thrombocythemia, developed antinuclear antibodies with arthralgia and myalgia. ARA criteria for systemic lupus erythematosus were not fulfilled but the therapy had to be interrupted. No patient developed thyroid dysfunction. In patients with hematologic malignancies, the dosage and the duration of IFN-alpha treatment do not seem to influence the appearance of autoantibodies, while female sex appears to be a risk factor.
α-干扰素（IFN-α）疗法在不同疾病中的广泛应用使其副作用受到关注，如自身免疫相关疾病，尤其是甲状腺自身免疫功能障碍。关于肝炎和非血液系统肿瘤的数据已有报道，而关于血液系统恶性肿瘤的数据则不完整。我们研究了54例连续的血液系统恶性肿瘤患者中自身免疫相关紊乱和甲状腺功能障碍的发生率，这些患者接受重组人IFN-α治疗的平均时间为15.9±8.9个月。我们的结果将血液系统恶性肿瘤中作为IFN-α治疗副作用的自身免疫功能障碍的发生率降至最低。我们仅在3名女性患者（占总数的5%）中检测到自身抗体的出现：2例患者（1例患有原发性血小板增多症，1例患有多发性骨髓瘤）出现抗甲状腺球蛋白抗体，但无临床症状；1例患有原发性血小板增多症的患者出现抗核抗体，并伴有关节痛和肌痛。虽未达到系统性红斑狼疮的美国风湿病学会（ARA）标准，但治疗不得不中断。没有患者出现甲状腺功能障碍。在血液系统恶性肿瘤患者中，IFN-α治疗的剂量和持续时间似乎不会影响自身抗体的出现，而女性似乎是一个危险因素。
