干扰素治疗慢性骨髓增殖性肿瘤的临床意义  

Therapeutic Effect of Interferon on Chronic Myeloproliferative Neoplasm Patients

作　　者：丁莉[1] 许娜[1] 黄彬涛[1] 高冠论[1] 肖雅娟[1] 周璇[1] 卢绮思[1] 李琳[1] 李玉玲[1] 黄继贤[2] 刘晓力[1] 

机构地区：[1]南方医科大学南方医院血液科,广州510515 [2]韶关市粤北人民医院血液科,韶关512000

出　　处：《肿瘤防治研究》2015年第4期385-388,共4页Cancer Research on Prevention and Treatment

基　　金：广州市科技攻关计划-科技攻关引导项目(2006Z3-E0401)

摘　　要：目的评价干扰素-α(IFN-α)对慢性骨髓增殖性肿瘤(MPN)患者的临床疗效。方法回顾性分析110例进展期MPN病例,其中包括76例JAK2V617F突变阳性或阴性原发性血小板增多症(ET)患者,34例JAK2V617F突变阳性真性红细胞增多症(PV)患者,分别接受IFN-α及羟基脲(HU)治疗半年以上,分析其临床数据,评价疗效和不良反应,并进行随访。结果 JAK2V617F(+)的ET及PV患者,IFN及HU治疗组间总缓解率差异无统计学意义(89.5%vs.85.7%;87.5%vs.83.3%,P>0.05),但IFN治疗组5年无疾病进展生存率显著高于HU治疗组(84.2%vs.52.4%;87.5%vs.50.0%,P<0.05)。JAK2V617F(-)的ET患者,IFN和HU治疗组间总缓解率(82.4%vs.78.9%)及5年无疾病进展生存率(58.8%vs.57.9%)间差异均无统计学意义(P>0.05)。IFN治疗组患者治疗过程中血栓事件、脾肿大、骨髓纤维化发生率均较HU治疗组低,且HU治疗组血液学(1~2级)不良反应较IFN组更多见,差异有统计学意义(P<0.05)。结论 JAK2V617F突变阳性的ET和PV患者使用干扰素治疗可获得较好的无疾病进展生存,且对JAK2V617F阳性PV患者摆脱静脉放血治疗效果理想。Objective To evaluate the therapeutic effect of interferon alpha(IFN-α) on patients with chronic myeloproliferative neoplasm(MPN). Methods We retrospectively made an analysis of 110 advanced MPN patients diagnosed, including 76 essential thrombocytosis(ET) patients with or without JAK2V617 F mutation and 34 polycythemia vera(PV) patients with JAK2V617 F mutation. All patients received IFN-α or hydroxyurea(HU) therapy for more than 6 months. The clinical data of efficacy and side effects were observed and compared. Results The overall response rate(ORR) between IFN-α and HU treatment groups of ET and PV patients with JAK2V617 F mutations had no significant difference(89.5% vs. 85.7%;87.5% vs. 83.3%, P>0.05), but the 5-year progression-free survival(PFS) rate of IFN-α and HU treatment groups showed significant difference(84.2% vs. 52.4%;87.5% vs. 50.0%, P<0.05). ORR(82.4% vs. 78.9%) and 5-year PFS rate(58.8% vs. 57.9%) between IFN-α and HU treatment groups of ET patients without JAK2V617 F mutations had no significant difference(P>0.05). The thromboembolic events, splenomegaly, bone marrow fibrosis of IFN-α treatment group were lower than those of HU treatment group; while hematologic adverse reactions of HU treatment group(Grade 1-2) was more than that of IFN-α treatment group(P<0.05). Conclusion ET and PV patients with JAK2V617 F mutations who were treated with IFN-α could get a favorable progressionfree survival, and PV patients with JAK2V617 F mutations could get rid of phlebotomy.

关 键 词：慢性骨髓增殖性肿瘤 干扰素-Α 疗效 JAK2V617F突变 

分 类 号：R733.3[医药卫生—肿瘤]