[Treatment of HTLV-I-associated myelopathy with alpha-interferon and high-dose of gamma-globulin].
We administered alpha-interferon (alpha-IFN) and gamma-globulin (gamma-gl) to patients with HTLV-I-associated myelopathy (HAM). Patients selected for this study fulfilled the diagnostic criteria of HAM by Osame et al. As for alpha-IFN, 12 patients were injected intramuscularly with a dose of 3 X 10(6) IU/day of alpha-IFN for 28 days. As for gamma-gl, 10 patients were injected intravenously with a dose of 10 g/day of human gamma-gl for 5 days. alpha-IFN exerted therapeutic effects in 7 of 12 patients and gamma-gl in 6 of 10. The therapeutic effects were shown by the improvement in time for a 20-meter walk, muscle power of lower limbs and urinary frequency. All patients having a history of improvement by corticosteroid therapy showed beneficial responses to both treatments with alpha-IFN and gamma-gl. Contrarily, patients who had not improved by corticosteroid therapy did not show any improvement after gamma-gl and alpha-IFN administration. The therapeutic effects of gamma-gl and alpha-IFN were observed predominantly in cases with shorter duration of illness, more marked abnormality in cerebral MRI findings and higher CSF antibody titers to HTLV-I. There was no correlation between the therapeutic efficacy and clinical severity or serum antibody titers to HTLV-I. We conclude that therapies with alpha-IFN and gamma-gl were safe and effective for the treatment of HAM.
Department of Internal Medicine, Saga Medical School.
Y
Y
Kuroda
H
H
Takashima
C
C
Endo
R
R
Neshige
R
R
Kakigi
D000328:Adult; D000368:Aged; D005260:Female; D015481:HTLV-I Antibodies / Q000032:analysis; D006801:Humans; D007116:Immunization, Passive; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D007370:Interferon Type I / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000628:therapy*; D005719:gamma-Globulins / Q000008:administration & dosage*
D015481:HTLV-I Antibodies; D007370:Interferon Type I; D005719:gamma-Globulins