Low doses of interferon-alpha are as effective as higher doses in inducing remissions and prolonging survival in chronic myeloid leukemia.

Abstract:

OBJECTIVE:To determine the toxicity and efficacy of low-dose interferon-alpha therapy in inducing remissions and prolonging survival in patients with chronic myeloid leukemia. DESIGN:Phase II evaluation and comparison with historical control patients and other series in which the investigators used higher interferon-alpha doses. SETTING:Tertiary care leukemia research clinic. PATIENTS:41 patients with newly diagnosed or previously treated chronic-phase, Philadelphia chromosome-positive chronic myeloid leukemia received interferon-alpha at a dose of 2 x 10(6) U/m2 body surface area daily for 28 days and then three times weekly. MEASUREMENTS:Complete blood counts and physical examinations were done monthly to determine hematologic remission and toxicity. To determine karyotypic response, bone marrow cytogenetic analyses were done at 6 monthly intervals in patients who achieved a complete hematologic remission. In addition, Kaplan-Meier survival curves and median survival values were generated from diagnosis and the start of therapy with interferon-alpha. RESULTS:70% of patients treated with low-dose interferon-alpha within 1 year of diagnosis achieved a complete hematologic remission, and 22% of these patients had a major or complete karyotypic response. Investigators who used higher interferon-alpha doses in similar patient populations have reported complete hematologic remission rates of 59% to 70% and major and complete cytogenetic response rates of 16% to 29%. The Kaplan-Meier estimated 5-year survival rate of minimally pretreated patients in our study is 73% (95% CI, 51% to 95%), which compares favorably with survivals reported by investigators who used higher doses. The estimated yearly cost of the interferon-alpha used in our study is $5953 compared with a median of $24,375 for the higher doses used by other investigators. Less toxicity was also observed. CONCLUSION:Low-dose interferon-alpha is as effective as higher-dose interferon-alpha in inducing remissions and prolonging survival in patients with chronic myeloid leukemia but is considerably less expensive and toxic.

journal_name

Ann Intern Med

authors

Schofield JR,Robinson WA,Murphy JR,Rovira DK

doi

10.7326/0003-4819-121-10-199411150-00002

subject

Has Abstract

pub_date

1994-11-15 00:00:00

pages

736-44

issue

10

eissn

0003-4819

issn

1539-3704

journal_volume

121

pub_type

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