INTERFERON-ALPHA PRODUCES SUSTAINED CYTOGENETIC RESPONSES IN CHRONIC MYELOGENOUS LEUKEMIA - PHILADELPHIA CHROMOSOME-POSITIVE PATIENTS
INTERFERON-ALPHA PRODUCES SUSTAINED CYTOGENETIC RESPONSES IN CHRONIC MYELOGENOUS LEUKEMIA - PHILADELPHIA CHROMOSOME-POSITIVE PATIENTS
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DOI：
10.7326/0003-4819-114-7-532
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发表时间：
1991-04-01
影响因子：
39.2
通讯作者：
GUTTERMAN, JU
中科院分区：
文献类型：
--
作者：
TALPAZ, M;KANTARJIAN, H;GUTTERMAN, JU
目的：评价α-干扰素治疗中完全细胞遗传学应答的频率和过程（α-干扰素）治疗的慢性粒细胞白血病患者。设计：在连续患者中进行的两项前瞻性试验。设置：一个主要的三级癌症中心。患者：96例连续的慢性粒细胞白血病患者，病程少于1年。干预：患者肌内接受部分纯的IFN-α，3至9百万U/d（51名患者）或重组IFN-α-2a（Roferon，Hoffmann-LaRoche，Inc.，Nutley，新泽西），每天500万U/m2体表面积（45名患者）.测量：进行血液学和细胞遗传学检查.主要结果：70名患者（73%）达到血液学缓解（95% CI，63%~ 81%），18名（19%）在至少一次细胞遗传学检查中完全抑制费城染色体。在用部分纯IFN-α治疗的51名患者中的7名或14%（CI，6%至26%）和用重组IFN-α-2a治疗的45名患者中的11名或24%（CI，13%至40%）中诱导了完全细胞遗传学应答。两组完全细胞遗传学缓解率差异为10.7%（CI，-5%至26%; P > 0.2）。11例患者有持久的，持续的，完整的细胞遗传学反应从6个月到超过45个月（中位数，超过30个月）。结论：这项研究是第一次显示持续的，完整的细胞遗传学反应的慢性粒细胞白血病患者的一个子集与单药治疗。这种缓解的性质，即是否依赖于持续治疗，需要进一步研究。
Objectives: To evaluate the frequency and the course of complete cytogenetic responses in interferon-alpha (IFN-alpha)-treated patients with chronic myelogenous leukemia.Design: Two prospective trials in consecutive patients.Setting: A major tertiary cancer center.Patients: Ninety-six consecutive patients with chronic myelogenous leukemia with disease duration of less than 1 year.Intervention: Patients received partially pure IFN-alpha intramuscularly, from 3 to 9 million U/d (51 patients) or recombinant IFN-alpha-2a (Roferon, Hoffmann-LaRoche, Inc., Nutley, New Jersey), 5 million U/m2 body surface area daily (45 patients).Measurements: Hematologic and cytogenetic tests were administered.Main Results: Seventy of the patients (73%) achieved hematologic remission (95% CI, 63% to 81%), and 18 (19%) had complete suppression of the Philadelphia chromosome on at least one cytogenetic test. A complete cytogenetic response was induced in 7 of 51 or 14% (CI, 6% to 26%) of the patients treated with the partially pure IFN-alpha and in 11 of 45 or 24% (CI, 13% to 40%) of the patients treated with recombinant IFN-alpha-2a. The difference in complete cytogenetic response between the two groups was 10.7% (CI, -5% to 26%; P > 0.2). Eleven patients had durable, ongoing, complete cytogenetic responses from 6 to more than 45 months (median, more than 30 months).Conclusion: This study was the first to show sustained, complete cytogenetic responses in a subset of patients with chronic myelogenous leukemia treated with single-agent therapy. The nature of this remission, that is, whether it depends on continuous therapy, requires further study.