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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 22, 2003 Accepted January 27, 2004 Randomized comparison of low dose versus high dose interferon-alfa in chronic myeloid leukemia: Prospective collaboration of three joint trials by the MRC and HOVON groups Hanneke C Kluin-Nelemans, Georgina Buck, Saskia le Cessie, Sue Richards, H B Beverloo, J H 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* Hematology, University Medical Center Groningen, Groningen, The Netherlands Clinical Trial Service Unit, Oxford, United Kingdom Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands Hematology, Leiden University Medical Center, Leiden, The Netherlands Hematology, The John Radcliffe Hospital, Oxford, United Kingdom Hematology, University Medical Center Nijmegen, Nijmegen, The Netherlands City Hospital NHS Trust, Birmingham, United Kingdom Hematology, University Medical Center Amsterdam, Amsterdam, The Netherlands Addenbrooke's NHS Trust, Cambridge, United Kingdom Hematology/Oncology, Medical Center OLVG, Amsterdam, The Netherlands North Hampshire Hospital, Basingstoke, United Kingdom Leicester Royal Infirmary, Leicester, United Kingdom Hematology, Western General Hospital, Edinburgh, United Kingdom * Corresponding author; email: p.shepherd{at}ed.ac.uk. The optimal dose of interferon-alfa (IFN) for 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 HOVON and British Medical Research Council cooperative groups jointly performed randomized trials in newly diagnosed CML 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 cells <5x109/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 to 1.46), progression free survival, complete hematological or major cytogenetic responses. Fewer patients in the low dose group abandoned IFN for reasons other than transplant or disease (p=0.002, 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 is advised, to minimize toxicity and costs. 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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