[低风险红细胞增多症的治疗策略]。

Shuichi Ota
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引用次数: 0

摘要

多发性红细胞症(PV)患者的治疗选择取决于患者的年龄和血栓形成史。标准治疗方法是低剂量阿司匹林和抽血术治疗低风险的红细胞增多症,高风险的红细胞增多症则需进行细胞再生治疗。血栓事件和 PV 克隆扩张导致的疾病进展会影响 PV 的预后。虽然抽血疗法能有效控制血细胞比容水平,但对疾病进展或与 PV 相关的症状没有影响。在西方国家,干扰素(IFN)一直被用作 PV 的细胞再生疗法。长期的 IFN 治疗已被证明可导致持续的血液学缓解和分子反应。每两周给药一次的罗匹干扰素-α-2b(罗匹干扰素-IFN)最近已经上市。对多发性骨髓瘤患者进行的临床试验表明,Ropeg-IFN 治疗安全有效,可减少 JAK2V617F 等位基因的负担。Ropeg-IFN最终可能会影响年轻的低风险PV患者的长期血液学缓解和分子反应,甚至有可能治愈。
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[Treatment strategies for low-risk polycythemia vera].

Treatment selection for patients with polycythemia vera (PV) is based on patient age and history of thrombosis. The standard treatment is low-dose aspirin and phlebotomy for low-risk PV, with cytoreductive therapy added for high-risk PV. Thrombotic events and disease progression due to PV clone expansion affect the prognosis of PV. Although phlebotomy is effective in controlling hematocrit level, it has no effect on disease progression or PV-related symptoms. In Western countries, interferon (IFN) has been used as a cytoreductive therapy for PV. Long-term IFN therapy has been shown to result in sustained hematologic remission and molecular responses. Ropeginterferon-α-2b (ropeg-IFN), which is administered every two weeks, has recently become available. Clinical trials in patients with PV have shown that ropeg-IFN treatment is safe and efficacious, reducing JAK2V617F allele burden. Ropeg-IFN could ultimately affect long-term hematologic remission and molecular response in younger patients with low-risk PV, and may even offer a cure.

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