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Induction and maintenance alpha-interferon therapy in myelofibrosis with myeloid metaplasia
G Barosi1, L N Liberato, A Costa
1Dipartimento di Medicina Interna e Terapia Medica (Sez. Clinica Medica 2), IRCCS Policlinico S. Matteo, Pavia, Italy.
Abstract:
In 12 patients having myelofibrosis with myeloid metaplasia (MMM), recombinant- alpha interferon (r-alpha INF) was given for 16 weeks at an initial dose of 3 x 10(6) U/day as a cytoreductive agent. At the end of the 16th wk, Hb showed minor changes; WBC were reduced from 43 x 10(9)/l, range 6.4-69.4, to 16 x 10(9)/l, range 5-39 (p = 0.05); platelets decreased from 845 x 10(9)/l, range 215-1748, to 370 x 10(9)/l, range 96-730 (p = 0.005). 2 cases responded at the starting dose, while the effective dose was 5 x 10(6) U/d in the others. Minor changes in spleen size were noted, while no significant changes in bone marrow fibrosis occurred. After induction therapy, 3 patients were allocated to maintenance therapy (from 10 up to 34 months). To maintain platelet count lower than 500 x 10(9)/l, the required r-alpha-INF dose was constantly 10 MU/wk, while the same result was not achieved in 1 case with hydroxyurea, 1 g/die. The association with hydroxyurea, 500 mg/die, allowed reduction of the r-alpha INF dose to 6 MU/die in 1 other case.
Insights
Recombinant alpha interferon effectively reduced white blood cells and platelets in myelofibrosis with myeloid metaplasia patients. Maintenance therapy with interferon alpha proved more effective than hydroxyurea for platelet control.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Myelofibrosis with myeloid metaplasia (MMM) is a myeloproliferative neoplasm.
- Cytoreductive therapy is essential for managing MMM symptoms and complications.
Purpose of the Study:
- To evaluate the efficacy of recombinant alpha interferon (r-alpha INF) as a cytoreductive agent in patients with MMM.
- To assess the effectiveness of r-alpha INF in controlling hematological parameters and compare it with hydroxyurea for maintenance therapy.
Main Methods:
- 12 patients with MMM received r-alpha INF for 16 weeks.
- Initial dose was 3 x 10(6) U/day, adjusted as needed.
- Hematological parameters (Hb, WBC, platelets) were monitored.
- Spleen size and bone marrow fibrosis were assessed.
- Maintenance therapy and combination therapy with hydroxyurea were evaluated.
Main Results:
- Significant reduction in WBC (p=0.05) and platelets (p=0.005) was observed.
- Effective dose ranged from 3 to 5 x 10(6) U/day.
- Minor changes in spleen size; no significant change in bone marrow fibrosis.
- Maintenance therapy with r-alpha INF (10 MU/wk) effectively controlled platelet counts, outperforming hydroxyurea in one case.
Conclusions:
- Recombinant alpha interferon demonstrates significant cytoreductive effects in MMM patients.
- Interferon alpha is a viable option for managing thrombocytosis in MMM.
- Combination therapy may allow for reduced interferon alpha dosage.