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Interferon-Alpha Produces Sustained Cytogenetic Responses in Chronic Myelogenous Leukemia: Philadelphia Chromosome-Positive Patients

Moshe Talpaz, MD; Hagop Kantarjian, MD; Razelle Kurzrock, MD; Jose M. Trujillo, MD; and Jordan U. Gutterman, MD
[+] Article, Author, and Disclosure Information

Grant Support: In part by Hoffmann-LaRoche and by the Clayton Foundation for Research. Dr. Gutterman is a senior Clayton Foundation Investigator.

Requests for Reprints: Moshe Talpaz, MD, Department of Clinical Immunology and Biological Therapy, Box 41, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.

Current Author Addresses: Drs. Talpaz, Kantarjian, Kurzrock, Trujillo, and Gutterman: University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.

©1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(7):532-538. doi:10.7326/0003-4819-114-7-532
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Objectives: To evaluate the frequency and the course of complete cytogenetic responses in interferon-alpha (IFN-α)-treated patients with chronic myelogenous leukemia.

Design: Two prospective trials in consecutive patients.

Setting: A major tertiary cancer center.

Patients: Ninety-six consecutive patients with chronic myelogenous leukemia with disease duration of less than 1 year.

Intervention: Patients received partially pure IFN-α intramuscularly, from 3 to 9 million U/d (51 patients) or recombinant IFN-α2a (Roferon, Hoffmann-LaRoche, Inc., Nutley, New Jersey), 5 million U/m2 body surface area daily (45 patients).

Measurements: Hematologic and cytogenetic tests were administered.

Main Results: Seventy of the patients (73%) achieved hematologic remission (95% CI, 63% to 81%), and 18 (19%) had complete suppression of the Philadelphia chromosome on at least one cytogenetic test. A complete cytogenetic response was induced in 7 of 51 or 14% (CI, 6% to 26%) of the patients treated with the partially pure IFN-α and in 11 of 45 or 24% (CI, 13% to 40%) of the patients treated with recombinant IFN-α2a. The difference in complete cytogenetic response between the two groups was 10.7% (CI, - 5% to 26%; P > 0.2). Eleven patients had durable, ongoing, complete cytogenetic responses from 6 to more than 45 months (median, more than 30 months).

Conclusion: This study was the first to show sustained, complete cytogenetic responses in a subset of patients with chronic myelogenous leukemia treated with single-agent therapy. The nature of this remission, that is, whether it depends on continuous therapy, requires further study.





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