TREATMENT OF ADULT T-CELL LEUKEMIA-LYMPHOMA WITH A COMBINATION OF INTERFERON-ALFA AND ZIDOVUDINE
TREATMENT OF ADULT T-CELL LEUKEMIA-LYMPHOMA WITH A COMBINATION OF INTERFERON-ALFA AND ZIDOVUDINE
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DOI：
10.1056/nejm199506293322603
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发表时间：
1995-06-29
影响因子：
158.5
通讯作者：
LEVINE, AM
中科院分区：
文献类型：
--
作者：
GILL, PS;HARRINGTON, W;LEVINE, AM
背景资料。感染人类T细胞嗜淋巴病毒I型，一种逆转录病毒，可导致一种独特的癌症，成人T细胞白血病-淋巴瘤。尽管使用了细胞毒性化疗，急性T细胞白血病和淋巴瘤患者的中位生存期很短。方法：我们用口服齐多夫定(200 mg五次乳制品)和干扰素α(Intron A，每天500万至1000万单位，皮下注射)治疗19例急性或淋巴瘤T细胞白血病-淋巴瘤。这些患者中有7人在接受多药细胞毒化疗后复发或对治疗无效。58%的患者(11/19)取得了主要反应，其中26%(5/19)的患者完全缓解。先前细胞毒治疗失败的四名患者出现了重大反应，其中两名患者完全缓解。6例患者存活超过12个月，是自59个月以上停止治疗以来最长的缓解。齐多夫定和干扰素α的组合对成人T细胞白血病-淋巴瘤具有活性，即使在先前细胞毒治疗失败的患者中也是如此。该方案在成人T细胞白血病-淋巴瘤治疗中的作用有待进一步评估。
Background. Infection with the human T-cell lymphotropic virus type I, a retrovirus, can cause a distinctive cancer, adult T-cell leukemia-lymphoma. The median survival of patients with the acute and lymphomatous forms of the disease is short, despite the use of cytotoxic chemotherapy.Methods: We treated 19 patients with acute or lymphomatous forms of adult T-cell leukemia-lymphoma with oral zidovudine (200 mg five times dairy) and interferon alfa (Intron A, 5 million to 10 million units subcutaneously each day). Seven of these patients had either relapsed after multiagent cytotoxic chemotherapy or failed to respond to that treatment.Results. Major responses were achieved in 58 percent of the patients (11 of 19), including complete remission in 26 percent (5 of 19). Four patients in whom prior cytotoxic therapy had failed had major responses, two of which were complete remissions. Six patients have survived for more than 12 months, with the longest remission since the discontinuation of treatment lasting more than 59 months.Conclusions. The combination of zidovudine and interferon alfa has activity against adult T-cell leukemia-lymphoma, even in patients in whom prior cytotoxic therapy has failed. This regimen should be evaluated further for its role in the treatment of adult T-cell leukemia-lymphoma.