Molica S, Tucci L, Levato D, Levato L, Manfredi L
Divisione di Ematologia, Ospedale Regionale A. Pugliese, Catanzaro, Italy.
Tumori. 1993 Jun 30;79(3):195-7. doi: 10.1177/030089169307900307.
To investigate therapeutic activity and safety of alpha-interferon (alpha-IFN) in combination with chlorambucil (CLB) and prednisone (PDN), we treated 9 low-grade non-Hodgkin lymphoma patients with clinical evidence of relapsed (5 cases) or resistant (4 cases) disease with such an association.
In all instances, treatment consisted of alpha-2a IFN administered by subcutaneous route thrice weekly for 3 weeks, CLB, 5 mg/day for 21 days, and PDN, 30 mg three times a week for 3 weeks. Cycles were repeated every 28 days.
A well-documented clinical response was observed in 6 (4 CRs+2 PRs) of 9 patients. Interestingly, 3 of 4 CRs were achieved in patients with histologically proven bone marrow involvement. Median duration of response was 18.5 months (range, 4-29 months). Myelosuppression was a common side effect. Two patients experienced grade 3 hematologic toxicity which did not preclude continuation of therapy.
As new purine analogues are not currently available, the combination of alpha-IFN, CLB, and PDN may represent, in our opinion, a valid therapy for patients not eligible for aggressive therapy such as autologous bone marrow transplantation.
为研究α-干扰素（α-IFN）联合苯丁酸氮芥（CLB）及泼尼松（PDN）的治疗活性与安全性，我们采用这种联合方案治疗了9例有复发（5例）或耐药（4例）临床证据的低度非霍奇金淋巴瘤患者。
在所有病例中，治疗方案包括皮下注射α-2a干扰素，每周3次，共3周；CLB，每日5mg，共21天；PDN，每周3次，每次30mg，共3周。每28天重复一个周期。
9例患者中有6例（4例完全缓解+2例部分缓解）出现了有充分记录的临床反应。有趣的是，4例完全缓解患者中有3例是组织学证实有骨髓受累的患者。中位缓解持续时间为18.5个月（范围4 - 29个月）。骨髓抑制是常见的副作用。2例患者出现3级血液学毒性，但这并未妨碍继续治疗。
鉴于目前尚无新的嘌呤类似物，我们认为，对于不符合自体骨髓移植等积极治疗条件的患者，α-IFN、CLB和PDN联合方案可能是一种有效的治疗方法。
