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Clinical investigation of human alpha interferon in chronic myelogenous
leukemia
M Talpaz, HM Kantarjian, KB McCredie, MJ Keating, J Trujillo and J Gutterman
Fifty-one patients with previously untreated or minimally treated chronic
myelogenous leukemia in chronic phase received human alpha interferon 3 to
9 X 10(6) units intramuscularly (IM) daily until complete hematologic
remission, then at doses ranging from 3 X 10(6) units every other day to 9
X 10(6) units daily. Forty-one (80%) patients achieved a hematologic
response, 36 (71%) of them attaining a complete hematologic remission with
normal peripheral WBC and differential counts. Responding patients showed
continuous but slow normalization of several other blood and marrow
parameters including platelet counts, serum lactic dehydrogenase and B12
levels, and marrow cellularity and maturation index. Suppression of the
Philadelphia chromosome on serial cytogenetic studies of marrow metaphases
was documented in 20 of the 36 patients who achieved complete hematologic
remission (56%; 39% of total group), eight of whom (22%) had a decrease of
the Philadelphia chromosome-positive metaphases to less than 35%. These
changes were persistent for 6 months or longer in 18 patients, seven of
whom had continuous suppression of the Philadelphia chromosome to less than
90% for a median of 30+ months (range 21+ to 39+ months). After a median
follow-up period of 37 months, 25 patients remain in continued disease
control with interferon therapy. The projected 3-year survival rate is 76%,
with a yearly death rate of 6%, 9%, and 9% in the first 3 years. Response,
Philadelphia chromosome suppression, and survival were significantly better
among patients in the low-risk category compared to intermediate- and
high-risk categories, as defined by a multivariate analysis-derived
prognostic model. The projected 3- year survival rate was 94% for patients
who achieved a complete hematologic remission on interferon therapy and 45%
for those who did not. Thirteen patients have developed blastic crisis, six
with lymphoid and three with undifferentiated morphology. We conclude that
human leukocyte alpha interferon effectively controls chronic myeloid
leukemia and allows reappearance of diploid hemopoietic cells in some
patients.
Volume 69,
Issue 5,
pp. 1280-1288,
05/01/1987
Copyright © 1987 by The American Society of Hematology
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