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Immunotherapy with recombinant human interleukin-2 and recombinant
interferon-alpha in lymphoma patients postautologous marrow or stem cell
transplantation
A Nagler, A Ackerstein, R Or, E Naparstek and S Slavin
Department of Bone Marrow Transplantation, Hadassah University Hospital,
Jerusalem, Israel.
Immune-mediated effects appear to play a major role in controlling minimal
residual disease (MRD). We, therefore, investigated the role of recombinant
human interleukin-2 (rIL-2) given concomitantly with interferon-alpha
(IFN-alpha) in malignant lymphoma (ML) patients with responding disease
following autologous bone marrow or blood stem cell transplantation
(ABSCT). Fifty-six patients were included in this investigation. Thirty-two
patients had non-Hodgkin's lymphoma (NHL) and 24 patients had Hodgkin's
disease (HD). Sixty-one patients (NHL 36, HD 25) served as historical
controls. Patients from both groups had similar demographic
characteristics, the same stage of disease at presentation, status of
disease at transplantation, conditioning regimens, and type of transplant.
rIL-2 and IFN-alpha were self- administered in two cycles beginning 2.5 to
10.5 months (median, 4 months) posttransplant and separated by a 4-week
interval. Each cycle consisted of IFN-alpha subcutaneously (SC) 3 x 10(6)
U/d x 5 d/wk combined with rIL-2 SC 3 to 6 IU/m2/d x 5 d/wk for 4 weeks.
The incidence of survival and disease-free survival (DFS) was significantly
higher in the group under investigation than in the historical controls (P
< .01). Of 56 patients with ML treated with IFN-alpha + rIL-2, 45
patients are DFS (80.4%) after a follow-up of 7 to 78 months (median, 34
months), whereas in the historical controls, 32 of 61 (52.5%) patients are
disease free, in a follow-up of 4 to 84 months (median, 23 months)
posttransplant (P < .01). Our preliminary results are encouraging and
suggest that home administered immunotherapy with IFN- alpha and rIL-2 is
relatively well tolerated and may intensify remission in ML patients with
MRD following ABSCT.
Volume 89,
Issue 11,
pp. 3951-3959,
06/01/1997
Copyright © 1997 by The American Society of Hematology
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