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Blood, 15 June 2004, Vol. 103, No. 12, pp. 4408-4415. Prepublished online as a Blood First Edition Paper on March 9, 2004; DOI 10.1182/blood-2003-10-3605. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-10-3605v1 103/12/4408    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kluin-Nelemans, H. C. Articles by Shepherd, P. Search for Related Content PubMed PubMed Citation Articles by Kluin-Nelemans, H. C. Articles by Shepherd, P. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Randomized comparison of low-dose versus high-dose interferon-alfa in chronic myeloid leukemia: prospective collaboration of 3 joint trials by the MRC and HOVON groups Hanneke C. Kluin-Nelemans, Georgina Buck, Saskia le Cessie, Sue Richards, H. Berna Beverloo, J. H. Frederik Falkenburg, Tim Littlewood, Petra Muus, David Bareford, Hans van der Lelie, Anthony R. Green, Klaas J. Roozendaal, Alison E. Milne, Claire S. Chapman, and Patricia Shepherd, for the UK CML Working Group of NCRI and the HOVON trials group From the Department of Hematology, University Medical Center, Groningen, the Netherlands; the Clinical Trial Service Unit, Oxford, United Kingdom; the Department of Medical Statistics and the Department of Haematology, Leiden University Medical Center, the Netherlands; the Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands; the Department of Hematology, The John Radcliffe Hospital, Oxford, United Kingdom; the Department of Hematology, University Medical Center, Nijmegen, the Netherlands; City Hospital National Health Service (NHS) Trust, Birmingham, United Kingdom; the Department of Hematology, University Medical Center, Amsterdam, the Netherlands; Addenbrooke's NHS Trust, Cambridge, United Kingdom; the Department of Hematology/Oncology, Medical Center Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, the Netherlands; North Hampshire Hospital, Basingstoke, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; and the Department of Haematology, Western General Hospital, Edinburgh, Scotland. The optimal dose of interferon-alfa (IFN) for chronic myeloid leukemia (CML) is unknown. Retrospective analyses suggest that low doses are as effective as high doses, with less toxicity and fewer patients abandoning the drug. The Dutch Hemato-Oncology Association (HOVON) and British Medical Research Council (MRC) cooperative groups jointly performed randomized trials in newly diagnosed CML patients, comparing high-dose IFN (5 MIU/m2 daily) with low-dose (3 MIU, 5 times a week). Both arms allowed additional hydroxyurea to keep the white blood cell count lower than 5 x 109/L. Quality of life data were collected in a subset of patients. Between 1993 and 2001, 407 patients were randomized. At a median follow-up of 53 months, there were no significant differences in overall survival (odds ratio = 1.09, 95% confidence interval, 0.81-1.46), progression-free survival, and complete hematologic or major cytogenetic responses. Fewer patients in the low-dose group abandoned IFN for reasons other than transplant or progressive disease (P = .002, 58% vs 72% at 5 years). Quality of life data showed comparable results in both arms for most factors. There is no evidence of benefit for high-dose IFN compared with low-dose for the treatment of CML. Therefore, when IFN is combined with other drugs, low-dose IFN is advised, to minimize toxicity and costs. (Blood. 2004;103:4408-4415) CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Kreil, M. Pfirrmann, C. Haferlach, K. Waghorn, A. Chase, R. Hehlmann, A. Reiter, A. Hochhaus, N. C. P. Cross, and for the German Chronic Myelogenous Leukemia (CML) Heterogeneous prognostic impact of derivative chromosome 9 deletions in chronic myelogenous leukemia Blood, August 15, 2007; 110(4): 1283 - 1290. [Abstract] [Full Text] [PDF] M. Baccarani, G. Saglio, J. Goldman, A. Hochhaus, B. Simonsson, F. Appelbaum, J. Apperley, F. Cervantes, J. Cortes, M. Deininger, et al. Evolving concepts in the management of chronic myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet Blood, September 15, 2006; 108(6): 1809 - 1820. [Abstract] [Full Text] [PDF] S. Parmar, J. Smith, A. Sassano, S. Uddin, E. Katsoulidis, B. Majchrzak, S. Kambhampati, E. A. Eklund, M. S. Tallman, E. N. Fish, et al. Differential regulation of the p70 S6 kinase pathway by interferon {alpha} (IFN{alpha}) and imatinib mesylate (STI571) in chronic myelogenous leukemia cells Blood, October 1, 2005; 106(7): 2436 - 2443. [Abstract] [Full Text] [PDF] T. Kober, J. Bohlius, S. Trelle, and A. Engert Second Biannual Report of the Cochrane Haematological Malignancies Group J Natl Cancer Inst, April 6, 2005; 97(7): E1 - E. [Full Text]

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