Russo D, Candoni A, Grattoni R, Minisini R, Rosti G
Chair of Hematology, Udine University, Italy.
Haematologica. 1997 May-Jun;82(3):348-50.
Nine Ph+ CML patients in chronic phase who were hematologically and/or karyotypically unresponsive to recombinant-IFN alpha 2a (rIFN alpha 2a) and neutralizing-rIFN alpha 2a Abs negative were shifted from rIFN alpha 2a to lymphoblastoid-IFN alpha (IFN alpha-Ly) therapy. After 3 months of IFNa-Ly treatment, the hematologic response was reinduced in 3 out of the 6 pts who were resistant to previous rIFN alpha 2a therapy, and was maintained in 2 out of 3 patients who were hematologically but not karyotypically responsive to rIFN alpha 2a. After 6 and 12 months, the hematologic response was progressively lost, being present only in 3 out of 7 and in 2 out of 3 evaluable patients respectively. None of the hematologically responsive patients achieved a karyotypic response (Ph neg. metaphases-0%). One patient, who was hematologically responsive, continued being treated with IFN alpha-ly for 36 months but he did not achieve any karyotypic response. The results of this study suggest that in the unresponsive and neutralizing-rIFN alpha 2a Abs negative CML patients a change in therapy, by using a non cross-reactive type of IFN alpha, would not be advantageous.
9例处于慢性期的Ph+慢性粒细胞白血病（CML）患者，血液学和/或细胞遗传学上对重组干扰素α2a（rIFNα2a）无反应且中和性rIFNα2a抗体阴性，从rIFNα2a治疗转为淋巴母细胞样干扰素α（IFNα-Ly）治疗。IFNα-Ly治疗3个月后，6例既往对rIFNα2a治疗耐药的患者中有3例再次诱导出血液学反应，3例血液学有反应但细胞遗传学无反应的患者中有2例维持了血液学反应。6个月和12个月后，血液学反应逐渐消失，分别仅在7例可评估患者中的3例和3例中的2例中存在。血液学有反应的患者均未达到细胞遗传学反应（Ph阴性中期-0%）。1例血液学有反应的患者继续接受IFNα-Ly治疗36个月，但未达到任何细胞遗传学反应。本研究结果表明，在无反应且中和性rIFNα2a抗体阴性的CML患者中，改用非交叉反应类型的IFNα进行治疗并无益处。
