干扰素α-2b联合低剂量阿糖胞苷治疗慢性髓细胞白血病的临床研究

TREATMENT OF INTERFERON ALFA-2B COMBINED WITH LOW-DOSE CYTARABINE IN CHRONIC MYELOGENOUS LEUKEMIA

目的:探讨慢性髓细胞白血病(CML)患者使用干扰素α蛳2b(IFNα蛳2b)联合低剂量阿糖胞苷(LD Ara蛳C)治疗,其血液学和细胞遗传学的缓解率,寻找治疗CML的新途径。方法:采用IFNα蛳2b(300万U/d)+Ara蛳C(20mg·m2·d-1,每月用10 d)治疗CML慢性期(CP)患者30例,检测治疗后血液学缓解率和细胞遗传学缓解率,并与IFNα蛳2b+羟基脲(Hu)治疗组和单纯Hu治疗组作对照。结果:Hu+IFNα蛳2b+LD Ara蛳C治疗组治疗6个月的CHR率、总CHR率和Ph染色体阳性细胞下降病例百分数均显著高于IFNα蛳2b+Hu治疗组(P=0.004、P<0.005和P=0.009)和单纯Hu治疗组(P=0.006、P<0.005和P<0.005),CML急变发生率低于单纯Hu治疗组(P<0.005),而且发生急变的时间晚,5 a生存率明显高于IFNα蛳2b+Hu治疗组(P=0.014)和单纯Hu治疗组(P<0.005)。结论:CML(CP)患者采用IFNα蛳2b+LD Ara蛳C治疗可显著提高CML患者的CHR率,提高CML患者的细胞遗传学缓解率,延长CML患者的生存期。

Objective:To explore the hematologic remission rate and cytogenetic response rate of treatment of interferon alfa-2b combined with low-dose cytarabine in chronic myelogenous leukemia and search new methods of treating chronic myelogenous leukemia.Methods:30patients with chronic myeloge-nous leukemia in chronic phase were treated by interferon alfa-2b(3×10 6 U/d)combined with low-dose cy-tarabine(20mg·m -2 ·d -1 ×10d)and the rates of complete hematologic remission and cytogenetic response were analyzed as compared with interferon alfa-2b+hydroxyurea and hydroxyurea alone.Results:The rate of complete hematologic remission was higher in the hydroxyurea-interferon-cytarabine group than in the interferon-hydroxyurea group and in the hydroxyurea group.The percentage of Philadelphia chromosome-positive cells decreased in the patients was higher in the interferon-cytarabine group than in the interferon-hydroxyurea group and in the hydroxyurea group.The blast crisis rate in chronic myelogenous leukemia was lower in the interferon-cytarabine group than in the interferon-hydroxyurea group and in the hydroxyurea group.The5-year survival rate was higher in the interferon-cytarabine group than in the interferon-hydrox-yurea group and in the hydroxyurea group.Conclusion:The combination of interferon alfa-2b and low-dose cytarabine can increase the rate of complete hematologic remission,increase the rate of cytogenetic response and prolong survival in patients in the chronic phase of chronic myelogenous leukemia.