Hematologic Remission and Cytogenetic Improvement Induced by Recombinant Human Interferon Alpha_Ain Chronic Myelogenous Leukemia

Abstract

We treated 17 patients who had Philadelphia-chromosome-positive chronic myelogenous leukemia (4 of whom had not received therapy and 13 of whom had been treated with hydroxyurea or busulfan for less than six months) with recombinant human interferon alpha A (Roferon-A). The interferon was given as 5 X 10(6) units per square meter of body-surface area per day intramuscularly during induction therapy. Fourteen patients responded to the treatment, of whom 13 had a hematologic remission and 1 had a partial hematologic remission. The median number of white cells in those patients declined from 60.9 X 10(3) to 3.4 X 10(3) per microliter, and the median number of platelets decreased from 476 X 10(3) to 231 X 10(3) per microliter. Among the five responding patients who had splenomegaly before treatment, the spleen size returned to normal in four and decreased by 75 percent in one, although it remained enlarged. Bone marrow cellularity declined from a median of 92.5 percent to a median of 57.5 percent. In six of the patients with hematologic remission, complete suppression of Philadelphia cells was observed on at least one examination. Of the 14 patients who responded, 11 have received the interferon therapy for 9 to 15 months. One patient relapsed during the treatment, and the treatment has been temporarily interrupted in two patients because of toxicity. These data are preliminary and will need further confirmation, but they suggest that recombinant human interferon alpha A is effective in inducing hematologic remission in most patients with benign-phase chronic myelogenous leukemia and in suppressing the Philadelphia chromosome in some of these patients.

Treatment of chronic myeloid leukemia in the imatinib era

“…It produced major cytogenetic responses in 15% to 25% patients and complete cytogenetic responses in 10% of patients. [12][13][14][15][16] The median survival of patients who received IFN-a was prolonged to approximately 7 years. [17][18][19] Recent updates from several studies reported 9-or 10-year overall survival (OS) rates that ranged from 27% to 35%.…”

Leucemia mieloide crônica e outras doenças mieloproliferativas crônicas

“…5 Na década de 80 se demonstrou a eficácia do alfa-interferon em estabelecer respostas hematológicas e citogenéticas. 6 Em 1996, foi publicado pela primeira vez o efeito do mesilato de imatinibe, atualmente utilizado no tratamento inicial da LMC com excelente eficácia terapêutica e baixa toxicidade. 7 O mesilato de imatinibe é atualmente o mais bem sucedido exemplo da utilização do conhecimento da patogênese molecular de uma neoplasia maligna humana, para o desenvolvimento de uma terapia.…”

GM-CSF can improve the cytogenetic response obtained with interferon-alpha therapy in patients with chronic myelogenous leukemia

“…Response criteria were defined as previously described. 6 The best cytogenetic response was defined by the lowest percentage of Ph chromosome-positive metaphases as follows: (1) complete, if the lowest percentage of Ph-chromosome-positive metaphases was 0%; (2) partial if it was between 1 and 34%; and (3) minor if it was between 35 and 90%. Major cytogenetic responses include complete and partial cytogenetic responses.…”