羟基脲联合干扰素α-2b序贯治疗真性红细胞增多症疗效观察

目的 观察羟基脲（HU）联合干扰素α-2b序贯治疗真性红细胞增多症的临床疗效及不良反应.方法 对确诊为真性红细胞增多症（PV）的18例患者依据其意愿分为羟基脲联合干扰素α-2b（IFN-α-2b）序贯治疗组（A组）8例及单用羟基脲组（B组）10例,以治疗5个月为近期观察时限,观察两组红细胞（RBC）、血红蛋白（Hb）、红细胞压积（HCT）、白细胞（WBC）、血小板（PLT）以及脾脏大小等指标变化;以治疗2年以上为远期观察时限,比较两组远期疗效.结果 两组患者治疗5个月后RBC、Hb、HCT、WBC、PLT以及脾脏大小等指标与治疗前相比均显著改善（P＜0.01）,但治疗后两组间上述指标比较差异无统计学意义（P＞0.05）.A组2年内未发生复发病例,8例均持续完全缓解（CR）,B组2年内持续缓解6例（其中CR3例）,HU减量过程中复发4例.两组远期疗效比较差异有统计学意义（P＜0.05）.IFN的主要不良反应为流感样症状,经口服非甾体消炎药可控制,病人可耐受.结论 羟基脲联合干扰素a-2b序贯治疗PV能使血细胞持续稳定在正常范围,安全性较好,值得基层医院推广.

Observation of curative effect of hydroxyurea combined with interferon alpha-2b in the sequential treatment of polycythemia vera

Objective To investigate the curative effect and adverse reactions of hydroxyurea（HU） combined with inter- feron alpha-2b in the sequential treatment of polycythemia vera.Methods 18 patients confirmed with polycythemia vera （PV） were divided into group A （treated with interferon alpha-2 combined with hydroxyurea, 8 cases）and group B （only treated with hydroxyurea, 10 cases） according to their wishes. In the recent observation period limited to 5 months, indexes such as red blood cell count （ RBC）, hemoglobin （ Hb）, hematocrit （ HCT）, white blood cell count （ WBC ）, platelet count （PLT） and the size of spleen were observed.In the long-term observation period of more than two years ,the long-term curative effects of the two groups were compared.Results After five months of treatment, RBC, Hb, HCT, WBC, PLT and the size of spleen significantly improved （ P 〈0. 01 ）, but there were no significant differences in those above-mentioned indexes between groups （ P 〉0.05）.The long-term observation showed that there were no relapse cases in group A,and 8 cases got sustained complete remission（CR） within two years.6 cases in group B got sustained remission（ 3 cases got CR） and 4 cases relapsed during HU reduction process within two years.There was significant difference in long term efficacy between the two groups（ P 〈0. 05 ）. The main adverse reactions caused by interferon were flu-like symptoms, which could be controlled by oral NSAIDS,and could be tolerated by patients.Conclusion Hydroxyurea combined with interferon alpha-2b in the sequential treatment of PV is safe.They can keep the blood cells stable in the normal range.Thus, it is worth popularizing in primary hospitals.