Use of alpha-2a-interferon to treat cytogenetic relapse of chronic myeloid leukemia after marrow transplantation
Use of alpha-2a-interferon to treat cytogenetic relapse of chronic myeloid leukemia after marrow transplantation
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DOI：
10.1182/blood.v90.7.2549.2549_2549_2554
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发表时间：
1997-10-01
期刊：
影响因子：
20.3
通讯作者：
Appelbaum, F
中科院分区：
文献类型：
--
作者：
Higano, CS;Chielens, D;Appelbaum, F
对14例未经处理的骨髓移植后细胞遗传学复发的慢性髓性白血病（CML）患者进行α -2a干扰素治疗。有8名男性和6名女性，平均年龄33岁。12名患者接受了来自相关异体供体的骨髓，2名患者接受了来自同基因供体的骨髓。开始使用干扰素时ph阳性中期的中位数百分比为55%（10%至87%）。每日干扰素的起始剂量为1至3 × 10(6) U/M-2/d，取决于初始血细胞计数，并根据耐受性进行调整，以维持白细胞计数在2,000至3,000/ μ L范围内，血小板计数大于60,000/ μ L。在细胞遗传学稳定缓解后，干扰素剂量降至维持水平。12例患者至少一次获得完全的细胞遗传学缓解。达到完全细胞遗传学缓解的中位时间为7.5个月（范围为1.5至12个月）。8例患者从首次记录的缓解时间起，细胞遗传学缓解持续10+至54+个月。在细胞遗传学完全缓解后，9例患者通过聚合酶链反应（PCR）检测bcr/abl融合基因mRNA转录物的存在。4例患者至少一次pcr阴性：2例患者一次pcr阴性；一名患者进行了一系列检测，结果为pcr阴性；一名患者进行了一系列pcr阴性外周血检查，同时获得了单个pcr阳性骨髓和阴性外周血检查。所有患者的中位随访时间为44个月（范围20至64个月）。干扰素一般耐受良好；只有一名有反应的患者由于毒性而无法继续使用干扰素。干扰素在很大比例（57%）的骨髓移植（BMT）后细胞遗传学复发患者中诱导持久的细胞遗传学缓解，而不会引起危及生命的毒性。(C) 1997年由美国血液病学会出版。
Fourteen patients with cytogenetic relapse of chronic myeloid leukemia (CML) after transplantation with unmanipulated bone marrow were treated with alpha-2a-interferon. There were eight men and six women, median age, 33 years. Twelve patients received marrow from a related allogeneic donor and two received marrow from a syngeneic donor. The median percentage of Ph-positive metaphases at the time of starting interferon was 55% (10% to 87%). Daily interferon was started at a dose of 1 to 3 x 10(6) U/M-2/d, depending on initial blood counts and was adjusted as tolerated to maintain the white blood count in the range of 2,000 to 3,000/mu L and the platelet count greater than 60,000/mu L. After a stable cytogenetic remission was achieved, the interferon dose was decreased to a maintenance level. Twelve patients achieved a complete cytogenetic remission on at least one occasion. Median time to achieve a complete cytogenetic remission was 7.5 months (range, 1.5 to 12). Eight patients remain in cytogenetic remission for 10+ to 54+ months from the time of first documented remission. After complete cytogenetic remission was established, nine patients were tested for the presence of the mRNA transcript of the bcr/abl fusion gene by polymerase chain reaction (PCR) testing. Four patients were PCR-negative on at least one occasion: two patients were PCR-negative on a single occasion; one patient had serial tests, which were PCR-negative; and one patient had serial PCR-negative peripheral blood tests with a single PCR-positive bone marrow obtained concurrently with a negative peripheral blood test. Median follow-up time for all patients is 44 months (range, 20 to 64). Interferon was generally well tolerated; only one responding patient was unable to continue interferon because of toxicity. Interferon induces durable cytogenetic remissions in a significant proportion (57%) of patients with cytogenetic relapse following bone marrow transplantation (BMT) without causing life-threatening toxicities. (C) 1997 by The American Society of Hematology.