EVALUATION OF 2'-DCF IN RECOMBINANT LEUKOCYTE IFN ALPHA IN HAIRY CELL LEUKEMIA

因为我们以前观察到大量的反应， 脱氧共福霉素治疗干扰素治疗失败后的毛细胞白血病， 我们开始了这个试验性方案来评估 重组干扰素α-2a和2 '脱氧共形霉素的组合。 该方案的缓解标准比其他方案更严格 研究中，我们要求没有毛细胞从双边 髂嵴骨髓活检获得两次， 两个月的间隔和改善外周血 血红蛋白要大于12克百分比，粒细胞计数要大于12克百分比， 大于1500每立方毫米，血小板计数 大于每立方毫米100，000。 大多数先前的研究 使用脱氧共形霉素的患者已宣布完全应答 单次单侧骨髓活检的结果 月15日 患者中，13例可评价反应，其中1例患者 由于弥漫性骨硬化和随之而来的 无法提供骨髓用于评估骨髓反应， 一个病人继续接受治疗 所有13例患者均部分 反应与少量残留的毛细胞留在 骨髓 完全缓解的标准是否 使用，我们将有10个完整的反应，仅基于一个 单侧骨髓活检。 看起来 脱氧共形霉素加干扰素的组合不提供 与单独DCF相比，完全缓解率显著提高。 因此，目前，脱氧共形霉素和 重组干扰素α-2a不能被推荐为 特工独自一人

Because we have previously observed substantial responses to deoxycoformycin in hairy cell leukemia after failure of interferon, we began this pilot protocol to evaluate the efficacy and toxicity of combined recombinant interferon alfa-2a and 2'deoxycoformycin. Response criteria in this protocol were more strict than other studies in that we required absence of hairy cells from bilateral iliac crest bone marrow biopsies obtained twice at approximately two month intervals and improvement of the peripheral blood hemoglobin to greater than 12 grams percent, granulocyte count to greater than 1500 per cubic millimeter, and platelet count to greater than 100,000 per cubic millimeter. Most previous studies using deoxycoformycin have declared patients complete responders on the basis of a single unilateral bone marrow biopsy. Of 15 patients, 13 are evaluable for response with one patient being inevaluable because of a diffuse bony sclerosis and consequent inability to provide marrow for assessment of the marrow response, and one patient continues on therapy. All 13 patients had partial responses with small numbers of residual hairy cells remaining in the bone marrow. Had standard criteria for complete remission been used, we would have had 10 complete responses based on only a single unilateral bone marrow biopsy. It appears that the combination of deoxycoformycin plus interferon provides no substantial improvement in complete response rate over dCF alone. At present, therefore, the combination of deoxycoformycin and recombinant interferon alfa-2a cannot be recommended over either agent alone.