Abstract |
To improve the management of chronic myeloid leukemia (CML) in a single center, we used interferon alpha (IFN alpha) to treat newly diagnosed CML patients and investigated the factors predictive of a major cytogenetic response. Fifty-two patients (pts) with a median age of 51.5 years (16-68), were given interferon alpha (IFN alpha) (5 millions/m2/day, subcutaneously). The median interval between diagnosis and IFN alpha was 41.5 days (0-160). The doses of INF alpha were adjusted to maintain the white blood cell (WBC) count between 1.5 and 5 x 10(9)/l and the platelet count between 50 and 100 x 10(9)/l. At diagnosis, Sokal's criteria were used to classify patients into three groups: low (n = 24), intermediate (n = 19) and high risk (n = 9). A complete hematological response (CHR) was achieved in 42 cases (80.7%). A partial response was present in nine; only one patient did not respond. By multivariate logistic regression analysis, only the age at diagnosis was found to influence the CHR rate (P = 0.06). Cytogenetic response was evaluated in 46 responder patients. Twenty-three patients achieved a major cytogenetic response (MCR) which was either partial ( > or = 65% pH negative cells) (n = 3) or complete (CCR) (n = 20). By univariate analysis, two disease-related variables were found to influence the MCR rate in 40 evaluable CHR patients: spleen size at diagnosis and peripheral blood blast percentage. However, using either univariate or multivariate analysis, the most significant factor was the achievement of CHR within 3 months (P < 0.0004 and P < 0.0002, respectively). These results show that IFN alpha can induce high rates of hematological and cytogenetic responses when administered in doses leading to myelosuppression. The achievement of CHR within 3 months could be useful to identify early, those patients who will not respond to IFN alpha and who need alternative treatments such as allogeneic or autologous stem cell transplantation.
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Authors | M Montastruc, F X Mahon, C Fabères, G Marit, C Bilhou-Nabera, P Cony-Makhoul, M Puntous, A Pigneux, J M Boiron, P Bernard |
Journal | Leukemia
(Leukemia)
Vol. 9
Issue 12
Pg. 1997-2002
(Dec 1995)
ISSN: 0887-6924 [Print] England |
PMID | 8609708
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Interferon Type I
- Recombinant Proteins
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Topics |
- Adolescent
- Adult
- Aged
- Female
- Humans
- Injections, Subcutaneous
- Interferon Type I
(administration & dosage)
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(genetics, mortality, therapy)
- Male
- Middle Aged
- Philadelphia Chromosome
- Predictive Value of Tests
- Recombinant Proteins
- Regression Analysis
- Survival Analysis
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