聚乙二醇干扰素-α2b治疗骨髓增殖性肿瘤的疗效及安全性

Efficacy and safety of peginterferon-α2b for treatment of myeloproliterative neoplasms

目的评价聚乙二醇干扰素-α2b对慢性骨髓增殖性肿瘤患者的临床疗效及不良反应。方法回顾性分析107例慢性骨髓增殖性肿瘤病例,其中包括95例原发性血小板增多症(ET),12例真性红细胞增多症(PV),接受聚乙二醇干扰素-α2b治疗12月以上,分析其临床数据,评价疗效和不良反应。结果接受聚乙二醇干扰素-α2b治疗后,ET及PV患者均获得较高的血液学缓解率(P<0.05),ET与PV治疗组间缓解率差异无统计学意义(0.86 vs 0.78,P>0.05),脾脏长厚径(脾脏指数)下降13.5%(95%CI:8.5%~18.5%),获得血液学缓解的患者MPN10评分下降较为显著(P<0.01)。PV患者JAK2V617F等位基因突变负荷中位值由67.23%(49.6%~84.86%)下降至19.7%(0.57%~74.6%)(P<0.05);ET患者JAK2V617F突变定量阳由48.97%(0.45%~74.24%)下降至22.1%(0.33%~65.42%)(P<0.05)。ET和PV患者观察到轻微不良反应(1-2级),差异无统计学意义。治疗期间血栓事件发生率为2.8%。未观察到严重不良反应。结论聚乙二醇干扰素-α2b治疗PV和ET获得较高的外周血细胞缓解率,具有缩脾疗效,并降低JAK2V617F基因突变负荷,不良反应轻微,多数患者可耐受。

Objective To evaluate the clinical efficacy and adverse reactions of peginterferon-α2b for treatment of chronic myeloproliferative neoplasms(MPN).Methods We retrospectively analyzed the data of 107 patients with MPN,including 95 with essential thrombocythemia(ET)and 12 with polycythemia vera(PV),who all received peginterferon-α2b treatment for at least 12 months.The clnical and follow-up data of the patients were analyzed to evaluate the efficacy and adverse reactions of the treatment.Results After receiving peginterferon-α2b treatment,both ET and PV patients achieved high hematological remission rates,and the total remission rates did not differ significantly between the two groups(86%vs 78%,P>0.05).In the overall patients,the spleen index decreased by 13.5%(95%CI:8.5%-18.5%)after the treatment.The patients with hematological remission showed a significantly greater reduction of the total symptom score than those without hematological remission(P<0.01).The median percentage of JAK2V617F allele load of PV patients decreased from 67.23%(49.6%-84.86%)at baseline to 19.7%(0.57%-74.6%)after the treatment,and that of JAK2V617F-positive ET patients decreased from 48.97%(0.45%-74.24%)at baseline to 22.1%(0.33%-65.42%)after the treatment.Mild adverse reactions(grade 1-2)were observed in both ET and PV groups without significant differences between them.The overall incidence of thrombotic events during the treatment was 2.8%in these patients,and no serious adverse reactions were observed.Conclusion For patients with chronic myelodysplasia,peginterferon-α2b treatment can achieve a high peripheral blood cell remission rate and maintain a long-term stable state with good effect in relieving symptoms such as splenomegaly.Peginterferon-α2b treatment caused only mild adverse reactions,which can be tolerated by most of the patients.