Arana-Trejo R M, Ovilla-Martínez R, Gómez-Morales E, Meillon-García L, Cervantes-Peredo A, González-Llaven J, Pizzuto-Chávez J, Kofman-Alfaro S
Departamentos de Hematología, Hospital General de México SSa. y Fac. de Medicina, UNAM, México.
Rev Invest Clin. 1997 May-Jun;49(3):209-14.
To evaluate if human recombinant interferon alpha (IFN) combined with chemotherapy is able to suppress the Philadelphia chromosome clone in patients with chronic myeloid leukemia (CML).
The cytogenetic evolution in 53 patients with CML in chronic phase de novo was studied. They received one of three treatment schemes: a) induction of remission with daunorubicin, vincristine, cytosine arabinose and prednisone (DOAP) and maintenance with IFN (n = 12); b) induction with busulfan (BUS) or hydroxyurea (HYDX) and maintenance with IFN (n = 26); c) induction with DOAP and maintenance with BUS (n = 15).
The remission was seen two to six months after the start of treatment: 10 had complete remission, six a partial one, 14 a minor remission and 23 none. The 16 with complete or partial response received treatment with IFN. None of the 15 cases maintained with BUS had complete or partial response. The proportion of cases with complete response (3/12) was slightly lower in patients treated with intensive chemotherapy (BUS/HIDX/IFN) than in those receiving conventional treatment (7/26).
Our results showed that: a) IFN in combination with chemotherapy induced partial or complete response in 30% of our cases; and b) intensive chemotherapy combined with IFN was not superior in terms of a cytogenetic response to treatment with monodrugs (BUS/HIDX) and IFN.
评估重组人α干扰素(IFN)联合化疗是否能够抑制慢性粒细胞白血病(CML)患者的费城染色体克隆。
对53例初发慢性期CML患者的细胞遗传学演变进行了研究。他们接受了以下三种治疗方案之一:a)用柔红霉素、长春新碱、阿糖胞苷和泼尼松诱导缓解(DOAP)并用IFN维持治疗(n = 12);b)用白消安(BUS)或羟基脲(HYDX)诱导并用IFN维持治疗(n = 26);c)用DOAP诱导并用BUS维持治疗(n = 15)。
治疗开始后2至6个月出现缓解:10例完全缓解,6例部分缓解,14例轻度缓解,23例无缓解。16例获得完全或部分缓解的患者接受了IFN治疗。15例接受BUS维持治疗的患者均未获得完全或部分缓解。强化化疗(BUS/HIDX/IFN)治疗的患者完全缓解率(3/12)略低于接受传统治疗的患者(7/26)。
我们的结果表明:a)IFN联合化疗在30%的病例中诱导了部分或完全缓解;b)强化化疗联合IFN在细胞遗传学反应方面并不优于单药(BUS/HIDX)和IFN治疗。