Casado L F, Steegmann J L, Picó M, Requena M J, Gómez C, Fernández-Rañada J M
Servicio de Hematología y Hemoterapia, Hospital Universitario de la Princesa.
Sangre (Barc). 1995 Oct;40(5):417-20.
Alpha-interferon (alpha-IFN) has been used in relapsed CML post-BMT, cytogenetic responses being attained in a number of cases (33 to 42%). In first chronic phase-CML patients such cytogenetic response has been correlated with the disappearance of the bcr region rearrangement, as seen with Southern-blot, but when RT-PCR is used only a small number of patients maintain undetectable traces of the Ph1 clone. A case of CML in haematological and cytogenetic relapse after BMT is reported who showed criteria of "accelerated" phase and, after treatment with alpha-IFN achieved haematologic, cytogenetic and molecular remission (Southern-blot and PCR negative) and disappearance of the abnormal clone with recovery of the donor haemopoiesis. The duration of the alpha-IFN cytogenetic response is longer than that of BMT (5 vs 3.5 yr), which is noteworthy. Taking the low toxicity of alpha-IFN into account, as compared with that of the other choices (a second BMT, IL2), this treatment should be offered to all patients with cytogenetic relapse after BMT.
α干扰素（α-IFN）已用于异基因骨髓移植（BMT）后复发的慢性粒细胞白血病（CML），许多病例（33%至42%）获得了细胞遗传学反应。在慢性期CML患者中，这种细胞遗传学反应与Southern印迹法检测到的bcr区域重排消失相关，但使用逆转录聚合酶链反应（RT-PCR）时，只有少数患者检测不到Ph1克隆的痕迹。本文报告了1例BMT后血液学和细胞遗传学复发的CML患者，该患者表现出“加速期”标准，经α-IFN治疗后达到血液学、细胞遗传学和分子学缓解（Southern印迹法和PCR均为阴性），异常克隆消失，供体造血恢复。α-IFN细胞遗传学反应的持续时间长于BMT（5年对3.5年），这一点值得注意。考虑到α-IFN与其他选择（第二次BMT、白细胞介素2）相比毒性较低，对于所有BMT后细胞遗传学复发的患者均应提供这种治疗。
