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目的研究重组人白细胞介素2(IL-2)联合-α干扰素激活骨髓自体移植治疗首次缓解期急性白血病的疗效及造血重建能力。方法24例首次缓解期急性白血病患者,其中男9例,女15例,中位年龄26岁(9～40岁);急性淋巴细胞白血病(ALL)13例,急性非淋巴细胞白血病(ANLL)9例,急性杂合性白血病(AHL)2例。预处理方案包括单次全身照射(sTBI)10 Gy+环磷酰胺(Cy)60 mg/kg×2次12例,sTBI 7 Gy+Cy 60 mg/kg×2次+阿糖胞苷(Ara-C)2 g/(m2.d)×2次5例,sTBI 9 Gy+Cy 60 mg/kg×2次+鬼臼乙叉苷(VP-16)200 mg/d×2次或鬼臼毒素(VM-26)200 mg/d×2次4例,MAC方案(马法兰Mel 160 mg/m2+Ara-C1 g/m2 Q12 h×6次+Cy60 mg/kg×2次)3例。进行IL-2联合-α干扰素激活自体骨髓并移植,移植后观察患者造血重建、长期无病生存率、移植相关死亡率、复发率及严重的移植相关并发症。结果移植后除2例患者因严重感染早期死亡外,所有22例患者获得造血重建。移植相关死亡3例,6例复发,15例患者持续完全缓解90个月(79～102个月),5年无病生存率及复发率分别为62.5%±9.9%及27.3%±9.5%。结论IL-2联合-α干扰素激活自体骨髓移植是治疗首次缓解期急性白血病的一种有效手段。
Objective To study the efficacy and hematopoietic reconstitution ability of recombinant human interleukin-2 (IL-2) combined with -α interferon-activated bone marrow autotransplantation in the treatment of first-episode acute leukemia. Methods Twenty-four patients with acute leukemia at initial remission were 9 males and 15 females with a median age of 26 years (range, 9 to 40 years), acute lymphoblastic leukemia (ALL), acute leukemia (ANLL), 9 Cases, acute heterozygous leukemia (AHL) in 2 cases. The pretreatment regimen consisted of 10 Gy of sTBI and 60 mg / kg of Cyclophosphamide (Cy) twice, sTBI 7 Gy + Cy 60 mg / kg x 2 + Ara-C ) 5 μg / (m2.d) × 2 times, sTBI 9 Gy + Cy 60 mg / kg × 2 times + VP-16 200 mg / d × 2 times or podophyllotoxin VM-26), 4 cases of 200 mg / d × 2 times and 3 cases of MAC regimen (melphalan 160 mg / m2 + Ara-C1 g / m2 Q12 h × 6 times + Cy60 mg / kg × 2 times). The autologous bone marrow was activated by IL-2 combined with -α interferon and transplanted. After transplantation, hematopoietic reconstitution, long-term disease-free survival rate, transplant-related mortality, relapse rate and severe graft-related complications were observed. Results All the 22 patients received hematopoietic reconstitution except 2 patients died of severe infection after transplantation. There were 3 deaths and 6 relapses after transplantation. The complete remission was 90 months (79-102 months) in 15 patients. The 5-year disease-free survival and recurrence rates were 62.5% ± 9.9% and 27.3% ± 9.5%, respectively. Conclusion IL-2 combined with IFN-α activates autologous bone marrow transplantation is an effective method for the treatment of acute leukemia in first remission.