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不同干扰素对慢性粒细胞白血病的长期治疗:三项研究结果

Long-term treatment of chronic myelogenous leukemia with different interferons: results from three studies.

作者信息

Niederle N, Kloke O, Wandl U B, Becher R, Moritz T, Opalka B

机构信息

Med. Klinik III, Städt, Krankenhaus, Leverkusen, Germany.

出版信息

Leuk Lymphoma. 1993 Jan;9(1-2):111-9. doi: 10.3109/10428199309148513.

Abstract

131 patients with Philadelphia (Ph') chromosome positive chronic myelogenous leukemia (CML) were treated with interferon (IFN) alpha or a combination of IFN alpha and IFN gamma. In study, 1, 13 not pretreated and 41 pretreated patients, 48 in chronic phase disease, 6 in accelerated phase, received 4 x 10(6) U/m2 IFN alfa-2b initially. After achievement of hematologic remission, the individually minimum effective dose was used for maintenance. There was no response in acute phase disease. Of the 48 patients with chronic phase disease, 22 achieved a hematologic remission (HR), 13 a partial HR (PHR), and 13 did not respond (NR) to IFN. No major cytogenetic response occurred in these patients, but two patients achieved a major molecular response in Southern blots, whereas PCR tests were positive. In a further randomized study, CML patients without prior therapy were treated initially with 4 x 10(6) U/m2 IFN alpha alone (arm A) or in combination with 50 micrograms IFN gamma (arm B). For maintenance, the maximum tolerable dose of IFN alpha was given (up to 10 x 10(6) U/day). Thirteen patients in arm A (54%) and 14 (56%) patients in arm B achieved a HR, 7 patients (29%) in arm A and 6 patients (24%) in arm B a PHR. No response could be induced in 4 patients (17%) of arm A and 5 patients (21%) of arm B. Major cytogenetic responses were observed in 5 (20%) patients of arm A and 5 patients (20%) of arm B. Major molecular responses were observed in 3 patients of arm A and 5 patients of arm B.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

131例费城(Ph')染色体阳性的慢性粒细胞白血病(CML)患者接受了α干扰素或α干扰素与γ干扰素联合治疗。在研究中,113例未接受过预处理和41例接受过预处理的患者,48例处于慢性期疾病,6例处于加速期,最初接受4×10⁶U/m²的α-2b干扰素治疗。达到血液学缓解后,使用个体最小有效剂量进行维持治疗。急性期疾病患者无反应。在48例慢性期疾病患者中,22例达到血液学缓解(HR),13例部分血液学缓解(PHR),13例对干扰素无反应(NR)。这些患者未出现主要细胞遗传学反应,但2例患者在Southern印迹中达到主要分子反应,而PCR检测呈阳性。在另一项随机研究中,未接受过先前治疗的CML患者最初单独接受4×10⁶U/m²的α干扰素(A组)或与50μgγ干扰素联合治疗(B组)。维持治疗时,给予α干扰素的最大耐受剂量(高达10×10⁶U/天)。A组13例患者(54%)和B组14例患者(56%)达到HR,A组7例患者(29%)和B组6例患者(24%)达到PHR。A组4例患者(17%)和B组5例患者(21%)未诱导出反应。A组5例患者(20%)和B组5例患者(20%)观察到主要细胞遗传学反应。A组3例患者和B组5例患者观察到主要分子反应。(摘要截短于250字)

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