Nemunaitis J, Rosenfeld C, Getty L, Boegel F, Meyer W, Jennings L W, Zeigler Z, Shadduck R
Western Pennsylvania Cancer Institute, Pittsburgh, USA.
Am J Clin Oncol. 1995 Jun;18(3):189-93. doi: 10.1097/00000421-199506000-00002.
Tumor necrosis factor (TNF) inhibits hematopoietic cell proliferation. The combination of pentoxifylline (PTX) and ciprofloxacin (Cipro) has been previously shown to reduce circulating serum levels of TNF. In this Phase II trial 14 patients with advanced myelodysplastic syndrome were treated with PTX (2,000 mg/day) and Cipro (1,000 mg/day) in order to determine tolerability and effect on peripheral blood cell counts, progenitor cell responsiveness to cytokines and circulating serum levels of interleukin-6 (IL6) and TNF. Toxicity attributed to PTX and Cipro were limited to nausea in 4 patients. Peripheral blood cell counts, platelet transfusion requirements and red blood cell transfusion requirements did not change during administration of PTX and Cipro (daily for 28 days). Marrow progenitor cells of patients entered into trial were less responsive to stimulation with cytokines in vitro at baseline and during the trial compared to normal volunteers. Eight patients had elevated IL6 levels before treatment with PTX and Cipro these levels did not change during therapy. Five patients had elevated TNF levels at baseline. There was a suggestion of decreased TNF levels during treatment with PTX and Cipro (P = .09). In conclusion, PTX and Cipro was well tolerated but no evidence of efficacy was observed.
肿瘤坏死因子（TNF）抑制造血细胞增殖。己酮可可碱（PTX）与环丙沙星（Cipro）联合用药先前已显示可降低循环血清中TNF的水平。在这项II期试验中，14例晚期骨髓增生异常综合征患者接受了PTX（2000毫克/天）和Cipro（1000毫克/天）治疗，以确定耐受性以及对外周血细胞计数、祖细胞对细胞因子的反应性和白细胞介素-6（IL6）及TNF循环血清水平的影响。归因于PTX和Cipro的毒性仅限于4例患者出现恶心。在给予PTX和Cipro期间（每天用药，共28天），外周血细胞计数、血小板输注需求和红细胞输注需求均未改变。与正常志愿者相比，进入试验的患者的骨髓祖细胞在基线时和试验期间对细胞因子刺激的体外反应性较低。8例患者在接受PTX和Cipro治疗前IL6水平升高，这些水平在治疗期间未发生变化。5例患者在基线时TNF水平升高。有迹象表明在接受PTX和Cipro治疗期间TNF水平降低（P = 0.09）。总之，PTX和Cipro耐受性良好，但未观察到疗效证据。
