Castello G, Lerza R, Cavallini D, Ballarino P, Cerruti A, Bogliolo G, Pannacciulli I
Dipartimento di Medicina Interna, Cattedra di Clinica Medica, Genova.
Recenti Prog Med. 1996 Jan;87(1):7-11.
In previous researches recombinant interferon alpha (IFN-alpha) has been demonstrated to significantly control red cell mass and thrombocytemia in patients with polycythemia vera (PV). Further evaluation of drug effectiveness and of modalities of maintenance therapy is warranted. We treated four patients with PV according to PVSG criteria with IFN-alpha (3 MU subcutaneously three times a week) for five months. Thereafter the starting dose was reduced to 1.5 MU three times a week. Treatment with IFN-alpha at the higher dosage induced regression in sizes of the spleen and a return to normal levels of peripheral blood platelets and leukocytes. Phlebotomies, previously performed to keep under control hematocrit values, were no more needed. During maintenance treatment with IFN-alpha reduced dose platelet level remained in the normal range, spleen size did not show further variation but hematocrit slowly rose and phlebotomies had to be resumed. These results confirm IFN-alpha effectiveness in PV, but suggest the need of relatively high dosages of the drug and difficulties in switching to a maintenance treatment.
在以往的研究中，重组干扰素α（IFN-α）已被证明能显著控制真性红细胞增多症（PV）患者的红细胞量和血小板增多症。有必要对药物疗效和维持治疗方式进行进一步评估。我们根据PVSG标准，用IFN-α（300万单位，皮下注射，每周3次）治疗4例PV患者，持续5个月。此后，起始剂量减至每周3次，每次150万单位。较高剂量的IFN-α治疗可使脾脏大小缩小，外周血血小板和白细胞水平恢复正常。此前为控制血细胞比容值而进行的放血治疗不再需要。在IFN-α减量维持治疗期间，血小板水平保持在正常范围，脾脏大小未进一步变化，但血细胞比容缓慢上升，不得不恢复放血治疗。这些结果证实了IFN-α对PV的疗效，但提示需要相对高剂量的药物，且转为维持治疗存在困难。
