羟基脲加干扰素治疗原发性血小板增多症的临床疗效研究

Clinical effectiveness of treatment with hydroxyurea plus interferon in patients with primary thrombocythemia

目的 :观察羟基脲加干扰素治疗原发性血小板增多症 (PT)的临床疗效。方法 :根据有无临床症状 ,将 38例PT患者分为有临床症状组及无临床症状组 ,根据用药情况再将 38例PT患者分为单用化疗组 (羟基脲0 .5 qd～0 .5tid ,加高三尖杉 )、α干扰素组 (上述化疗加α干扰素 3× 10 6IU qod～biw)和γ干扰素组 (上述化疗加γ干扰素 (1～ 3)× 10 6IUqd～qod)。 结果 :有临床症状组的患者发病时外周血血小板计数明显高于无临床症状组 (P <0 .0 1)。单用化疗组、α干扰素组与γ干扰素组疗效相似 ,总有效率分别为 91.7%、80 .0 %和 10 0 % (P >0 .0 5 )。三组治疗前后血小板计数分别为 (1137.0 0± 5 5 6 .5 0 )vs(74 4 .5 0± 4 84 .4 3)× 10 9/L、(114 6 .0 0± 32 5 .5 0 )vs(44 3.81± 2 13.0 2 )× 10 9/L和 (10 6 9.0 0± 2 4 3.70 )vs(44 0 .6 4± 14 1.72 )× 10 9/L。本研究中给予α干扰素无效的 2例患者改用γ干扰素 ,结果 1例取得缓解 ,1例进步。结论 :对于高危患者 ,若经济条件有限 ,可给予羟基脲、高三尖杉并抗栓胶囊等治疗 ,该治疗方法疗效明确 ,费用较低 ,副作用较少。对于α干扰素疗效欠佳的患者 。

Objective:To evaluate the effect of treatment with Hydroxyurea plus Interferon or not in patients with primary thrombocythemia.Method:According to clinical symptoms, the total 38 cases were divided into two groups: group with clinical symptom and group without clinical symptoms.According to drug therapy, the total 38 patients were divided into three groups: 12 ceses were treated with chemotherapy alone (hydroxyurea 0.5 qd ～ 0.5 tid +/- homoharringtonine); 10 cases were treated with interferon α combined with hydroxyurea (interferon α 3 ×10 6IU qod～biw)and 16 cases were treated with interferon γ combined with hydroxyurea (interferon γ 1～3×10 6IU qd～qod).Result:Onset of illness, the peripheral white blood cell in group with clinical symptom was significantly higher than that of group without clinical symptom (P< 0.01 ).The total efficiency showed no significant difference among chemotherapy alone group ( 91.7 %), interferon α group ( 80.0 %) and interferon γ group (100%)(P> 0.05 ). The platelet count of pre treatment versus post treatment among the three group was ( 1137.00 ± 556.50 )vs ( 744.50 ± 484.43 )×10 9/L?( 1146.00 ± 325.50 )vs( 443.81 ± 213.02 )×10 9/L and ( 1069.00 ± 243.70 )vs( 440.64 ± 141.72 )×10 9/L. Two cases treated with interferon α did not achieve clinicl effect, when they were treated with interferon γ, one achieved remission and the other achieved progression. Conclusion:To those of high grade PT with financial problem, we can treat them with hydroxyurea +/- homoharringtonine. It shows good effect, lower side effect and lower cost.IFN γ can be wsed in those PT patients who are not sensitive to IFN α.