A comparison of polychemotherapy and melphalan/prednisone for primary remission induction, and interferon-alpha for maintenance treatment, in multiple myeloma. A prospective trial of the German Myeloma Treatment Group

Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT)

“…This pattern of response is consistent with some of the previous studies of ␣-IFN treatment after conventional chemotherapy, where ␣-IFN has induced a prolongation of either both OS and PFS 8,16,17 or of PFS only, 9,10,18 but Bone Marrow Transplantation stands in contrast to other studies where no effect at all has been documented. 7,19,20 In the only randomized study of ␣-IFN maintenance treatment post-ASCT, 15 an early analysis at 4 years after transplantation demonstrated that ␣-IFN treatment was associated with a significant advantage in OS in all patients, and a significantly better PFS for the patients who achieved CR after transplantation, but not for those in PR. These differences, however, disappeared with time, and at 77 months post-ASCT no significant differences could be seen.…”

Maintenance treatment with interferon alpha-2b in multiple myeloma: a prospective randomized study from PETHEMA (Program for the Study and Treatment of Hematological Malignancies, Spanish Society of Hematology)

“…[20][21][22][23] In contrast to these observations, other trials have failed to show a significant advantage in response duration for IFN maintenance. 8,[24][25][26] Regarding overall survival, most available data, including our own study, suggest that there are no significant differences in survival from the time of randomization in patients maintained with IFN as compared to the observation group. 8,21,24,25 However, two studies have shown a significant survival prolongation in favor of IFN maintenance in patients achieving an objective response to inducation therapy and maintained with IFN.…”

“…8,[24][25][26] Regarding overall survival, most available data, including our own study, suggest that there are no significant differences in survival from the time of randomization in patients maintained with IFN as compared to the observation group. 8,21,24,25 However, two studies have shown a significant survival prolongation in favor of IFN maintenance in patients achieving an objective response to inducation therapy and maintained with IFN. 20,22 In addition, a third study showed a survival benefit of borderline significance (P = 0.049) from IFN maintenance when the statistical analysis was done after adjusting for chance imbalances in baseline prognostic factors.…”

“…[20][21][22][23][24][25][26] In our series, IFN had to be discontinued at some time in 20% of the patients. However, about 75% of our patients were able to receive at least 3 MU of IFN three times per week for all the planned period.…”

A clinician’s view of statistics

“…Peest et al 2 and Westin et al 3 interpreted their results as showing that interferon did not improve survival because in their studies p Ͼ .05. However, Mandelli's result of p ϭ .04 led him to recommend interferon treatment for all patients with multiple myeloma in remission.…”