Alpha-interferon in the treatment of nodular lymphomas.
Alpha-interferon in the treatment of nodular lymphomas.
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α-干扰素治疗结节性淋巴瘤。
DOI：
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
Longo Dl
中科院分区：
文献类型：
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作者：
Urba Wj;Longo Dl
结节性淋巴瘤患者最初对一些治疗方法有反应，但复发很常见，而且随着时间的推移，复发是不可避免的，尽管进一步治疗，大多数患者最终将死于淋巴瘤。最近证明了他们对α-干扰素的敏感性是有希望的。这种人类抗肿瘤作用的重要性在于，它可能是基于与传统药物不同的机制。不同剂量和方案的重组α-干扰素的I期试验表明，有效的血清水平可以通过肌肉(IM)、静脉(IV)或皮下(SC)途径获得。几乎所有患者都经历了不同程度的急性毒性，表现为发热、寒战、肌痛和头痛。耐受性通常在治疗的最初几周内发展为急性不良反应，无论剂量或时间表如何。疲劳和厌食症是最重要的不良反应，发生在治疗的前两周，通常持续到治疗期间。偶尔也有与中枢神经系统和心血管系统有关的不良反应的报道。在治疗期间观察到的主要实验室异常包括血液学参数的下降和肝功能测试的升高。α-干扰素的临床疗效，无论是天然的还是重组的，都已在未经治疗和严重预处理的结节淋巴瘤患者中得到证明。在最近的研究中，应答率接近50%；然而，只有不到一半的人是完全应答者。未来的方向包括将干扰素与细胞毒剂或其他生物反应调节剂相结合，并用作辅助治疗。
Patients with nodular lymphoma initially respond to a number of therapies but relapse is common and inexorable with time, and despite further therapy, most patients will ultimately die of their lymphoma. The recent demonstration of their sensitivity to alpha-interferon is promising. The importance of this human antitumor effect is that it is presumably based on mechanisms different from conventional agents. Phase I trials of various doses and schedules of recombinant alpha-interferon have shown that effective serum levels can be obtained by intramuscular (IM), intravenous (IV), or subcutaneous (SC) routes. Virtually all patients experienced some degree of acute toxicity manifested by fever, chills, myalgia, and headache. Tolerance usually developed to acute adverse effects within the first few weeks of therapy, regardless of dose or schedule. Fatigue and anorexia were the most important adverse reactions, occurring during the first two weeks of treatment and generally persisting for the duration of therapy. Occasional adverse effects relating to the central nervous and cardiovascular systems have been reported. Primary laboratory abnormalities observed during treatment include decreases in hematologic parameters and elevations of liver function tests. The clinical efficacy of alpha-interferon, both natural and recombinant, has been demonstrated in both untreated and heavily pretreated patients with nodular lymphoma. The response rate has approached 50% in recent studies; however, less than half were complete responders. Future directions include combination of interferon with cytotoxic agents or other biological response modifiers and use as adjuvant therapy.