INTERFERON-ALPHA-2A IN THE TREATMENT OF ACQUIRED IMMUNODEFICIENCY SYNDROME-RELATED KAPOSIS-SARCOMA
INTERFERON-ALPHA-2A IN THE TREATMENT OF ACQUIRED IMMUNODEFICIENCY SYNDROME-RELATED KAPOSIS-SARCOMA
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DOI：
10.1097/00002371-199102000-00006
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发表时间：
1991-02-01
影响因子：
3.9
通讯作者：
DZIEWANOWSKA, ZE
中科院分区：
文献类型：
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作者：
EVANS, LM;ITRI, LM;DZIEWANOWSKA, ZE
在一系列研究中，重组干扰素-α-2a（rIFN-alpha-2a，Roferon-A）单独给药（273例男性）或与长春碱联合给药（91例男性）治疗获得性免疫缺陷综合征（AIDS）相关卡波西肉瘤（KS）患者。 患者接受每日剂量范围为300万至5400万国际单位（I.U.）的rIFN-α-2a治疗。肌肉注射。 一剂3600万国际单位每天给药约10周，然后用相同剂量每周维持三次，产生最佳的总体治疗益处。 剂量递增方案为300万、900万和1800万I.U.每日一次，每次持续3天，随后注射3600万I.U.每日给药，在某些患者中产生了与急性毒性改善相当的治疗益处。 无机会性感染史或B症状（发热、盗汗或体重减轻）的患者更可能出现应答。 缓解率随着基线CD 4淋巴细胞计数的增加而增加，在CD 4计数大于400/mm 3的患者中为45.5%。 CD 4计数大于200/mm 3的应答患者与CD 4计数相似但肿瘤未随治疗消退的患者相比具有明显的生存优势。 添加长春碱会增加毒性，但不能提高缓解率或延长生存期。 副作用包括疲劳、发热、寒战、肌痛、头痛、厌食、恶心、腹泻和头晕。 部分患者血液学和肝功能检查出现轻度异常。 大多数不良反应随着持续治疗而减轻或消退。 我们的结论是，rIFN-α-2a提供了重要的治疗益处，在选定的一组患者与艾滋病相关的KS。
In a series of studies, recombinant interferon-alpha-2a (rIFN-alpha-2a, Roferon-A) was administered alone (273 men) or combined with vinblastine (91 men) to patients with acquired immunodeficiency syndrome (AIDS)-related Kaposi's sarcoma (KS). Patients were treated with daily doses of rIFN-alpha-2a ranging from 3 to 54 million international units (I.U.) administered intramuscularly. A dose of 36 million I.U. daily for approximately 10 weeks followed by a three times weekly maintenance schedule with the same dose resulted in the best overall therapeutic benefit. An escalating-dose regimen of 3, 9, and 18 million I.U. daily, each for 3 days, followed by 36 million I.U. daily, produced equivalent therapeutic benefit with amelioration of acute toxicity in some patients. Response was more likely in patients without a history of opportunistic infection or B symptoms (fever, night sweats, or weight loss). Response rate increased with increasing baseline CD4 lymphocyte count and was 45.5% in patients with a CD4 count of greater than 400/mm3. Responding patients with a CD4 count of greater than 200/mm3 had a distinct survival advantage over patients who had similar CD4 counts but whose tumors did not regress with therapy. The addition of vinblastine increased toxicity and did not improve the response rate or prolong survival. Side effects included fatigue, fever, chills, myalgias, headaches, anorexia, nausea, diarrhea, and dizziness. Mild abnormalities in hematologic and liver function tests occurred in some patients. Most adverse effects diminished or resolved with continued therapy. We conclude that rIFN-alpha-2a offers important therapeutic benefit in a select group of patients with AIDS-related KS.