ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00894.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:During the past 6 years, clinical trials employing α‐interferon (α‐IFN) in hairy cell leukemia (HCL) have shown dramatic improvement in the management of this disease. Complete remissions (CR), however, are relatively rare (10–15%) and a minority of patients (10–25%) do not respond adequately to α‐IFN. The possibility that the poor response to α‐IFN treatment could be related to a peculiar immunological phenotype of the hairy cell (HC) was investigated in this study. The results demonstrated that, in the majority of patients who failed to respond to α‐IFN, HC showed an immunological phenotype characterized by positivity with the CD5 monoclonal antibody which is usually absent on HC and characteristically expressed on B‐chronic lymphocytic leukemia cells. In fact, among the 10 HCL patients who presented with this phenotype, only 5 partial remissions (PR) and 5 minor responses (MR) were achieved, as opposed to the 3 complete remissions (CR), 19 PR and 3 MR observed in the 25 CD5‐negative patients. The possibility that a more extensive immunological analysis of HCL patients at diagnosis may be predictive of the response to IFN t

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00895.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00896.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00897.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:In 12 patients having myelofibrosis with myeloid metaplasia (MMM), recombinant‐ α interferon (r‐αINF) was given for 16 weeks at an initial dose of 3 times 106U/day as a cytoreductive agent. At the end of the 16th wk, Hb showed minor changes; WBC were reduced from 43 times 109/l, range 6.4–69.4, to 16 times 109/l, range 5–39 (p = 0.05); platelets decreased from 845 times 109/l, range 215–1748, to 370 times 109/l, range 96–730 (p = 0.005). 2 cases responded at the starting dose, while the effective dose was 5 times 106U/d in the others. Minor changes in spleen size were noted, while no significant changes in bone marrow fibrosis occurred. After induction therapy, 3 patients were allocated to maintenance therapy (from 10 up to 34 months). To maintain platelet count lower than 500 times 109/l, the required r‐α‐INF dose was constantly 10 MU/wk, while the same result was not achieved in 1 case with hydroxyurea, 1 g/die. The association with hydroxyurea, 500 mg/die, allowed reduction of the r‐αINF dose to 6 M

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00898.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Conventional treatment of symptomatic essential thrombocythemia (ET) consists of long‐term administration of myelosuppressive cytotoxic agents which, although efficacious in most cases, are associated with leukemogenic potential. Alpha‐interferon (IFN) exerts a dose‐dependent inhibitory influence on thrombopoiesis through a direct antiproliferative effect on megakaryocytic precursors. Therefore, it may provide a biologic, potentially non‐mutagenic alternative to conventional cytotoxic treatments. At daily doses ranging from 1 to 5 M.U., alpha‐IFN is efficacious in inducing a hematologic response in most patients with ET. Response to IFN is a gradual process. The median time to hematologic response varies from 1 to 3 months and a significant proportion of patients reach and maintain normal platelet counts with low doses (1–3 M.U./d). Normalization of marrow megakaryocytosis requires longer treatment (9–12 months). Also patients resistant to cytotoxic drugs may respond to alpha‐IFN, suggesting a lack of cross‐resistance between the two treatment modalities. Side‐effects, although not severe, represents a limit to the administration of adequate doses of IFN in about 25% of cases. Once hematologic response has been obtained, both low‐dose IFN and cytotoxic drugs are effective as maintenance. The full potentialities of alpha‐IFN in ET in combination with cytotoxic drugs or with other cytokines need to

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00899.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:In an ongoing phase II study we are evaluating the role of alpha‐2b recombinant interferon in Hodgkin's disease; the study design includes patients with high‐risk parameters who are treated by combination chemotherapy MOPP, ABVD, MOPP + ABVD or equivalent combinations. At the end of the therapeutic program which could include also radiotherapy, patients will be randomly assigned to receive alpha‐2b interferon at 3MU/day over 3 months and then 3MU/three times/week over 9 months or no further treatment. Up to September 1989, 107 patients were randomized; evaluable patients with a minimum follow‐up of 3 months are 95, 56 in the arm of interferon and 39 in the arm of no further treatment. The results are preliminary and differences could not be disclosed between the two arms concerning either the relapse rate or the incidence of infections. Tolerance and toxicity due to alpha‐2b interferon in patients with Hodgkin's disease could be defined as acceptably good considering that mild and reversible hematological toxicity was experienced in 12 (21%) patients; objective clinical toxicity was recorded in 4 (7%) patients although 7 (12%) patients refused to continue the treatment. Definite conclusions will be drawn when 100 patients per arm become

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00900.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:We treated 114 ph1+ chronic myeloid leukemia (CML) patients, 105 of whom were in chronic phase (CP) and 9 in accelerated phase (AP), with interferon alpha‐2b (IFN α‐2b) at intermittent or daily doses of 2–5 MU/m2. Of 35 previously untreated CP patients, 22 (63%) showed complete hematological response (CHR). This was significantly influenced by initial risk status. In 19 of the 22 CHR patients the median of ph1+ cells decreased from 100% to 58%. Of 36 patients pretreated for12 months, 21 (62%) obtained CHR. Cytogenetic improvement was observed in 10 cases, the median of ph1+ cells declining from 100% to 66%. 1 of 9 AP patients obtained CHR. After a median follow‐up of 32 months for the 63 CHR patients, 49 (78%) are still in disease control: 34 on IFN therapy, 15 after bone marrow transplantation (BMT) (13 autologous and 2 allogeneic). Blastic transformation (BT) occurred in 9 of 63 (14%) CHR patients and in 24 of 51 (47%) patients with less than CHR. IFN α‐2b has proved to be an effective treatment for CML. Its combination with other treatment modalities represents an interesting and promising approach for fut

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00901.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Since December 1987, 115 patients with HCL have been enrolled in a prospective multicenter study to evaluate the role of splenectomy after an induction therapy with alpha interferon. The group of patients was divided into two categories: those younger and those older than 65 years. The schedule of treatment with IFN was, respectively, 1.8 MU/sm/daily and 1.0 MU/daily. 33 patients were treated with r‐alpha‐2a, 34 with r‐alpha‐2b, and 25 with alpha‐Ly. To date, 92 patients are fully evaluable. The response was assessed every 3 months by bone marrow trephine biopsy. Patients in CR continued IFN therapy for 3 months and, if they were still in CR, could undergo an optional splenectomy. Patients in PR continued therapy for 12 months and subsequently were randomized for splenectomy or observation only. In these preliminary results of an ongoing protocol, CR was obtained in 5 cases (6%), PR in 59 (64%), MR in 25 (27%), NR in 3 (3%). Only 2 of the 5 patients in CR underwent splenectomy and are still in CR. Of the 59 patients in PR, only 15 completed 12 months of therapy. 9 patients in Group A were randomized, 4 were splenectomized and 5 were in the observation arm. All patients were splenectomized safely and no complications occurred. These preliminary results suggest that splenectomy could be effective in consolidating the response obtained

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00902.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:23 newly diagnosed patients affected by cutaneous T‐cell lymphoma were treated with sub‐cutaneous interferon alpha‐2a to evaluate the therapeutic efficacy and the toxicity of this agent. IFN was administered daily with dose escalation from 3 to 18 million units for 12 weeks; thereafter, patients induced into complete (CR) or partial (PR) remission were given IFN at maximal tolerated dose 3 times weekly for 6 or 9 months. The objective tumor response was observed in 17 patients (74%): 8 (35%) were CR and 9 (39%) were PR. A 74‐yr‐old patient died because of neutropenia and sepsis at the end of induction phase, while receiving IFN at dose of 18 million units. Disease stage is the initial feature predictive of response to IFN therapy. The dose schedule of this study was well tolerated: only 3 patients developed liver toxicity, while leukopenia was evident in 6 patients. Only 2 CR patients have relapsed, 18 and 24 months from response; the remaining 6 CR patients are in continuous complete remission with a median follow‐up of 41.8 months. 6 PR patients have progressed from 8 to 17 months after response, and in the 3 PR patients not yet progressed the response duration ranges from 20 to 24 months. In conclusion, interferon alpha‐2a is a very effective agent in therapy of untreated cutaneous T‐cell lymphoma with an overall respo

ISSN:0902-4441    

DOI:10.1111/j.1600-0609.1990.tb00903.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY