The role of alpha-interferon in multiple myeloma

Alpha-interferon (Ifn-alpha) has anti-tumor activity in vivo when used as a single agent in multiple myeloma (MM). However, the mechanisms responsible for this activity have not been clarified so far. Ifn-alpha has been therapeutically tested in a number of clinical trials for remission induction, maintenance therapy, and in different combinations with chemotherapy or steroids. The results of these trials are partially controversial and do not undoubtedly support Ifn-alpha treatment in any of these indications. However, meta-analyses using individual patient data or published results of the trials revealed small but significant advantages for MM patients treated with Ifn-alpha monotherapy for maintenance or in combination with conventional chemotherapy for remission induction. These advantages weigh against reduction of quality of life due to adverse effects commonly seen in Ifn-alpha treated MM patients and in addition relatively high treatment costs. Future efforts should be made to find prognostic factors determining effectiveness of Ifn-alpha therapy. Furthermore, the outcome of Ifn-alpha treatment should be improved by new therapy strategies based on a better understanding of the pathophysiological mechanisms influenced by Ifn-alpha in MM.