Long-term treatment of hairy cell leukemia with interferon-α: still a viable therapeutic option
Long-term treatment of hairy cell leukemia with interferon-α: still a viable therapeutic option
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DOI：
10.1007/s12254-016-0269-1
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发表时间：
2016-06-01
影响因子：
0.6
通讯作者：
Steurer, Michael
中科院分区：
文献类型：
--
作者：
Bohn, Jan-Paul;Gastl, Guenther;Steurer, Michael
经典毛细胞白血病 (HCL) 是一种罕见的惰性 BaEuro 细胞淋巴细胞增殖性疾病，于 1958 年首次被描述为一种独特的疾病实体。在二十多年没有有效的化疗方案和不到 5 年的惨淡预后后，只有引入干扰素欧洲α (IFNaEuro α) 才能使缓解率达到 80-90% 并改善生存。然而，如今，患者很少接受 IFN-α 治疗，因为嘌呤类似物被发现对 HCL 非常有效，在大多数情况下可促进接近正常的寿命。此外，继嘌呤类似物之后，出现了针对复发或难治性疾病患者的新治疗工具，例如利妥昔单抗和最近的维莫非尼。然而，在缺乏这些新药的长期安全性数据的情况下，当要避免嘌呤类似物的严重免疫抑制副作用时，IFN-α仍然可能代表一种可行的治疗选择。我们在此报告了一名 HCL 患者，该患者接受了多种治疗，包括喷司他丁、克拉屈滨，以及总共 164 个月的 IFNaEuro α 治疗，取得了长期的疾病控制。我们的案例表明，长期给予 IFN-α 并根据毒性和疾病活动性进行适当的剂量调整在 HCL 中是可行的，并且当嘌呤类似物被认为不合适时，可能仍然是可行的治疗选择。
Classic hairy cell leukemia (HCL) is a rare indolent BaEurocell-lymphoproliferative disorder, first described as a distinct disease entity in 1958. After more than two decades without effective chemotherapeutic options and a dismal prognosis of less than 5 years, only the introduction of interferonaEuro alpha (IFNaEuro alpha) allowed for response rates between 80-90 % and survival improvement. Nowadays, however, patients are rarely treated with IFN-alpha as purine analogues were found to be highly effective in HCL facilitating a near normal life span in most cases. Moreover, novel therapeutic tools for patients with relapsed or refractory disease after purine analogues have emerged such as rituximab and, more recently, vemurafenib. In the absence of long-term safety data for these novel agents, however, IFN-alpha may still represent a viable therapeutic option when the profound immunosuppressive side effects of purine analogues are to be avoided. We herein report a HCL patient, who has received multiple lines of therapy, including pentostatin, cladribine, and a total of 164 months of treatment with IFNaEuro alpha yielding long-term disease control. Our case illustrates that long-term administration of IFN-alpha with adequate dose-adjustments according to toxicity and disease activity is feasible in HCL and may still be a viable therapeutic option when purine analogues are considered unsuitable.