Umeda T, Aoki K, Yokoyama A, Ohara H, Hayashi O, Tanaka K, Nishioka K
Department of Dermatology, School of Medicine, Tokyo Medical and Dental University, Japan.
J Dermatol. 1998 Sep;25(9):569-72.
Combination adjuvant therapy with intravenous dimethyl triazeno imidazole carboxamide (DTIC), 1-[4-amino-2-methyl-5-pyrimidinyl]-methyl-3-[2-chloroethyl]-3-nitrosoure a hydrochloride (ACNU) and vincristine (VCR) and local injection of interferon-beta (IFN-beta) (DAV + IFN-beta therapy) has been widely applied to treat malignant melanoma, and its therapeutic effect is accepted in Japan. Natural killer (NK) activity, CD4+ and CD8+ T cell counts, CD4/CD8 ratio, and white blood cell counts were analyzed before and after DAV + IFN-beta therapy in order to validate its efficacy. After DAV + IFN-beta therapy, the CD4/CD8 ratio was elevated; however, numbers of both CD4+ and CD8+ T cells and NK activity were consecutively depressed. Peripheral lymphocytes were also decreased, possibly by myelosuppression due to the DAV therapy. The posttreatment suppression of NK activity appeared in spite of the administration of IFN-beta. It is suggested that a more effective adjuvant immunomodulator should be introduced to improve the therapeutic effect of the combination adjuvant chemotherapy in malignant melanoma.
静脉注射二甲基三氮烯咪唑甲酰胺（DTIC）、1-[4-氨基-2-甲基-5-嘧啶基]-甲基-3-[2-氯乙基]-3-亚硝基脲盐酸盐（ACNU）和长春新碱（VCR）联合辅助治疗，以及局部注射干扰素-β（IFN-β）（DAV + IFN-β疗法）已被广泛应用于治疗恶性黑色素瘤，其治疗效果在日本得到认可。为了验证DAV + IFN-β疗法的疗效，在治疗前后分析了自然杀伤（NK）活性、CD4+和CD8+ T细胞计数、CD4/CD8比值以及白细胞计数。DAV + IFN-β疗法后，CD4/CD8比值升高；然而，CD4+和CD8+ T细胞数量以及NK活性均持续降低。外周淋巴细胞也减少，可能是由于DAV疗法导致的骨髓抑制。尽管使用了IFN-β，治疗后NK活性仍受到抑制。建议引入更有效的辅助免疫调节剂，以提高联合辅助化疗对恶性黑色素瘤的治疗效果。
