Bourantas K L, Tsiara S, Christou L, Repousis P, Konstantinidou P, Bai M, Seferiadis K
Department of Internal Medicine, University Hospital, University of Ioannina Medical School, Greece.
Acta Haematol. 1996;96(2):79-82. doi: 10.1159/000203720.
Seven patients, 3 men and 4 women 48-72 years of age and suffering from idiopathic myelofibrosis were given a combination of recombinant human erythropoietin (r-hu-Epo), interferon-alpha-2b (IFN) and GM-CSF, in an attempt to treat their pancytopenia and marrow fibrosis. The dose of r-hu-Epo was 200 U/kg 3 times weekly, that of IFN was 3 x 10(6)/U 3 times weekly, and that of GM-CSF was 250 micrograms/m2/daily. The duration of therapy ranged from 3 to 6 months for r-hu-Epo and IFN and was 3 weeks for GM-CSF. The treatment regimen had a beneficial effect on all patients. The levels of hemoglobin increased in all patients but particularly in 5 (2 of whom had been dependent on red blood cell transfusions). Splenomegaly decreased significantly in 4 patients. Fibrosis in the bone marrow decreased in 2 patients. Three patients also had an increase in the number of white blood cells during the therapy with GM-CSF. We observed mild side effects in 6 of our patients. One patient had severe side effects from IFN and treatment was discontinued. In conclusion, the combination of r-hu-Epo, IFN and GM-CSF may improve the anemia (due to r-hu-Epo), increase the white blood cell count (due to GM-CSF) and reduce the marrow fibrosis (probably due to IFN) in patients with idiopathic myelofibrosis.
7例年龄在48至72岁之间、患有特发性骨髓纤维化的患者（3名男性和4名女性）接受了重组人促红细胞生成素（r-hu-Epo）、α-2b干扰素（IFN）和粒细胞巨噬细胞集落刺激因子（GM-CSF）的联合治疗，以尝试治疗他们的全血细胞减少症和骨髓纤维化。r-hu-Epo的剂量为200 U/kg，每周3次；IFN的剂量为3×10⁶/U，每周3次；GM-CSF的剂量为250微克/平方米/天。r-hu-Epo和IFN的治疗持续时间为3至6个月，GM-CSF为3周。该治疗方案对所有患者均有有益效果。所有患者的血红蛋白水平均升高，尤其是5名患者（其中2名曾依赖红细胞输血）。4名患者的脾肿大明显减轻。2名患者的骨髓纤维化减轻。3名患者在GM-CSF治疗期间白细胞数量也有所增加。我们观察到6名患者有轻微副作用。1名患者因IFN出现严重副作用而停止治疗。总之，r-hu-Epo、IFN和GM-CSF的联合应用可能改善特发性骨髓纤维化患者的贫血（由于r-hu-Epo）、增加白细胞计数（由于GM-CSF）并减少骨髓纤维化（可能由于IFN）。
