Interferon treatment for hairy cell leukemia. An update on a cohort of 69 patients treated from 1983 to 1986.
Interferon treatment for hairy cell leukemia. An update on a cohort of 69 patients treated from 1983 to 1986.
复制标题
干扰素治疗毛细胞白血病。
作者：
Spielberger Rt;R. Mick;M. Ratain;H. M. Golomb
我们报告了 1983 年至 1986 年间以干扰素 α-2b (IFN) 作为主要治疗的 69 名毛细胞白血病 (HCL) 患者的随访信息。截至 1993 年 4 月的随访显示，只有 14 名患者死亡。 61 名患者中，有 47 名完成了预期的 12 个月或更长时间的初始 IFN 治疗，最终被认为是 IFN 失败。 43 例需要重新治疗（41 例接受第二个疗程的干扰素治疗，2 例接受喷司他丁治疗）。 4 名患者在未接受进一步 HCL 治疗的情况下死亡。干扰素失效的中位时间为 31.3 个月。 14 名患者在完成最初 12 个月或更长时间的干扰素治疗后仍然活着，无需进一步治疗。 15 名患者在完成第二个疗程（1.0 年）干扰素治疗后的中位时间接受了第三个疗程的干扰素治疗。 18 名患者最终接受了喷司他丁治疗，10 名患者接受了 2-氯脱氧腺苷 (2-CdA) 治疗。 13 名患者出现了第二种恶性肿瘤；其中 6 名患者在开始干扰素治疗后 44.6 个月至 99.1 个月期间出现血液恶性肿瘤。我们的结论是，尽管干扰素提供了极好的姑息作用，但大多数患者最终需要使用干扰素或化疗进行进一步治疗。未来的 HCL 试验必须意识到第二种恶性肿瘤的风险。
We report follow-up information on 69 hairy cell leukemia (HCL) patients treated with interferon alfa-2b (IFN) as primary treatment from 1983 to 1986. Follow-up through April, 1993 shows that only 14 patients have expired. Forty-seven of the 61 patients completing the intended 12 or more months of initial IFN treatment were eventually considered IFN failures. Forty-three required re-treatment (41 received a second course of IFN and 2 received pentostatin). Four patients died without further therapy for HCL. The median time to interferon failure was 31.3 months. Fourteen patients are alive and have not required further treatment after completing their initial 12 or more months of interferon. Fifteen patients underwent a third course of interferon therapy at a median time after completion of a second course of IFN of 1.0 year. Eighteen patients were eventually treated with pentostatin and ten with 2-chlorodeoxyadenosine (2-CdA). Thirteen patients developed a second malignancy; six of these patients developed a hematologic malignancy between 44.6 months and 99.1 months after initiation of interferon therapy. We conclude that although interferon provides excellent palliation, that most patients will eventually require further treatment with interferon or chemotherapy. Future trials in HCL must be aware of the risk of second malignancies.