干扰素- α治疗对慢性髓性白血病患者淋巴细胞亚群的影响。

S Sacchi, J Cortes, H Kantarjian, M Talpaz
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摘要

干扰素- α (IFN-A)在慢性髓性白血病(CML)中的作用机制尚不清楚,但一些证据表明IFN-A具有免疫调节特性。我们对49例接受IFN-A治疗的慢性粒细胞白血病患者进行了前瞻性分析,目的是通过流式细胞术定量确定治疗对不同淋巴细胞亚群的影响,以及这种影响是否与对IFN-A的反应有关。无论对IFN-A的反应如何,所有患者淋巴细胞的绝对数量是相似的。在获得完全细胞遗传学应答(CCGR)的患者中,停止IFN-A治疗后,CD3+、CD4+、CD8+和CD19+淋巴细胞的绝对计数出现反弹。耐药疾病患者,以及有血液学反应但没有细胞遗传学反应的患者,CD19+细胞的绝对数量低于有任何细胞遗传学反应的患者。与对IFN-A反应较弱或无反应的患者相比,达到CCGR的患者CD56+细胞的绝对数量更高,并且这种情况在停止治疗后仍然存在。我们得出的结论是,与反应较小的患者相比,在使用IFN-A实现CCGR的CML患者中,CD19+和CD56+淋巴细胞的绝对数量增加。这些变化可能对疾病的控制产生功能上的影响。
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Effects of interferon-alpha therapy on lymphocyte subpopulations in patients with chronic myeloid leukemia.

The mechanism of action of interferon-alpha (IFN-A) in chronic myelogenous leukemia (CML) is not known, but some evidence points at the immune modulation properties of IFN-A. We conducted a prospective analysis on 49 patients with CML in chronic phase treated with IFN-A in order to identify the effect of therapy on different lymphocyte subpopulations as determined by flow cytometric quantification and whether this effect is associated with the response to IFN-A. The absolute number of lymphocytes was similar in all patients regardless of response to IFN-A. In patients achieving a complete cytogenetic response (CCGR) there was a rebound of the absolute count of CD3+, CD4+, CD8+, and CD19+ lymphocytes after discontinuation of therapy with IFN-A. Patients with resistant disease, as well as patients with hematologic response but no cytogenetic response, showed a lower absolute number of CD19+ cells than patients with any cytogenetic response. Patients who achieved a CCGR had a higher absolute number of CD56+ cells than patients with lesser response or no response to IFN-A, and this persisted after discontinuation of therapy. We conclude that an increase in absolute number of CD19+ and CD56+ lymphocytes is observed in CML patients achieving a CCGR with IFN-A compared to patients with lesser responses. These changes could have functional consequences in the control of the disease.

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