南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (6): 1029-1034.doi: 10.12122/j.issn.1673-4254.2023.06.20

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聚乙二醇干扰素-α2b治疗骨髓增殖性肿瘤的疗效及安全性

罗冬梅，罗 洁，梁瀚尹，何哲柔，陈 红，温紫玉，王 蔷，周 璇，刘晓力，许 娜   

  1. 南方医科大学南方医院血液科，广东 广州 510515
  • 出版日期:2023-06-20 发布日期:2023-07-06

Efficacy and safety of peginterferon-α2b for treatment of myeloproliterative neoplasms

LUO Dongmei, LUO Jie, LIANG Hanyin, HE Zherou, CHEN Hong, WEN Ziyu, WANG Qiang, ZHOU Xuan, LIU Xiaoli, XU Na   

  1. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Online:2023-06-20 Published:2023-07-06

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摘要： 目的 评价聚乙二醇干扰素-α2b对慢性骨髓增殖性肿瘤患者的临床疗效及不良反应。方法 回顾性分析107例慢性骨髓增殖性肿瘤病例，其中包括95例原发性血小板增多症（ET），12例真性红细胞增多症（PV），接受聚乙二醇干扰素-α2b治疗12月以上，分析其临床数据，评价疗效和不良反应。结果 接受聚乙二醇干扰素-α2b治疗后，ET及PV患者均获得较高的血液学缓解率（P<0.05），ET与PV治疗组间缓解率差异无统计学意义（0.86 vs 0.78，P>0.05），脾脏长厚径（脾脏指数）下降13.5%（95% CI：8.5%~18.5%），获得血液学缓解的患者MPN10评分下降较为显著（P<0.01）。PV患者 JAK2V617F等位基因突变负荷中位值由67.23%（49.6%~84.86%）下降至19.7%( 0.57%~74.6%)（P<0.05）；ET患者 JAK2V617F突变定量阳由48.97%（0.45%~74.24%）下降至22.1%（0.33%~65.42%）（P<0.05）。ET和PV患者观察到轻微不良反应（1-2级），差异无统计学意义。治疗期间血栓事件发生率为2.8%。未观察到严重不良反应。结论 聚乙二醇干扰素-α2b治疗PV和ET获得较高的外周血细胞缓解率，具有缩脾疗效，并降低JAK2V617F基因突变负荷，不良反应轻微，多数患者可耐受。

关键词: 骨髓增殖性肿瘤；真性红细胞增多症；原发性血小板增多症；聚乙二醇干扰素-α2b

Abstract: Objective To evaluate the clinical efficacy and adverse reactions of peginterferon-α2b for treatment of chronic myeloproliferative neoplasms (MPN). Methods We retrospectively analyzed the data of 107 patients with MPN, including 95 with essential thrombocythemia (ET) and 12 with polycythemia vera (PV), who all received peginterferon-α2b treatment for at least 12 months. The clnical and follow-up data of the patients were analyzed to evaluate the efficacy and adverse reactions of the treatment. Results After receiving peginterferon- α2b treatment, both ET and PV patients achieved high hematological remission rates, and the total remission rates did not differ significantly between the two groups (86% vs 78%, P>0.05). In the overall patients, the spleen index decreased by 13.5% (95%CI: 8.5%-18.5%) after the treatment. The patients with hematological remission showed a significantly greater reduction of the total symptom score than those without hematological remission (P<0.01). The median percentage of JAK2V617F allele load of PV patients decreased from 67.23% (49.6%-84.86% ) at baseline to 19.7% (0.57%-74.6%) after the treatment, and that of JAK2V617F-positive ET patients decreased from 48.97% (0.45%-74.24%) at baseline to 22.1% (0.33%-65.42% ) after the treatment. Mild adverse reactions (grade 1-2) were observed in both ET and PV groups without significant differences between them. The overall incidence of thrombotic events during the treatment was 2.8% in these patients, and no serious adverse reactions were observed. Conclusion For patients with chronic myelodysplasia, peginterferon-α2b treatment can achieve a high peripheral blood cell remission rate and maintain a long-term stable state with good effect in relieving symptoms such as splenomegaly. Peginterferon-α2b treatment caused only mild adverse reactions, which can be tolerated by most of the patients.

Key words: myeloproliferative neoplasms; polycythemia vera; essential thrombocythemia; peginterferon-α2b