Schwarzmeier J D
Abteilung für Hämatologie, Universitätsklinik für Innere Medizin I, Wien.
Wien Med Wochenschr. 1993;143(16-17):412-5.
Hairy cell leukemia (HCL) was one of the first malignancies in which therapy with natural interferon-alpha achieved complete remissions. In an early multicenter trial we could confirm the efficacy of IFN, especially of recombinant preparations. In more than 14 clinical studies using all types of IFN-alpha in dose ranges of 2.000,000 to 3.000,000 remission rates of 80 to 90% have been documented. The observation that interruption of IFN therapy may result in a relapse which responds again to IFN implies the need for continuous therapy with IFN at a low dose level in patients with HCL. Refractory relapses might respond to adenosine-desaminase-inhibitors. Own investigations show that the pancytopenia in HCL is a result of a lack of hematopoietic growth factors with a dominance of inhibitory factors such as TNF-alpha. Thus IFN therapy does not directly act on hairy cells but rather via influences on other cellular regulatory mechanisms.
毛细胞白血病(HCL)是最早使用天然α干扰素治疗可实现完全缓解的恶性肿瘤之一。在一项早期多中心试验中,我们证实了干扰素的疗效,尤其是重组制剂的疗效。在超过14项临床研究中,使用各种类型的α干扰素,剂量范围为200万至300万,缓解率记录为80%至90%。中断干扰素治疗可能导致复发,而复发对干扰素再次有反应,这一观察结果表明,HCL患者需要在低剂量水平持续使用干扰素治疗。难治性复发可能对腺苷脱氨酶抑制剂有反应。我们自己的研究表明,HCL中的全血细胞减少是缺乏造血生长因子的结果,其中抑制因子如肿瘤坏死因子-α占主导地位。因此,干扰素治疗并非直接作用于毛细胞,而是通过影响其他细胞调节机制起作用。