[Value of interferon-alpha in treatment of chronic myeloid leukemia]

In 1983 Talpaz et al. (43) for the first time demonstrated the efficacy of interferon-alpha (IFN-alpha) for the treatment of patients with chronic myelogenous leukemia (CML). This observation has been confirmed by several study groups in the consecutive years. An overview over the 7 largest trials including more than 400 patients reveals response rates (partial and complete hematological remissions) of 55 to 91%. In contrast to conventional chemotherapy IFN-alpha treatment resulted in a decrease of Philadelphia-chromosome positive metaphases (cytogenetic remissions) in 19 to 47% of these patients. A complete disappearance of the Philadelphia chromosome was found in 5 to 10% of patients. The following factors influence the response to IFN-alpha in patients with CML: phase and duration of the disease, several well defined risk factors, and IFN-dose. Currently available data are strongly suggestive for a survival benefit of patients with cytogenetic remissions, although definitive prove by phase-III trials is lacking. Actual studies focus on combinations of IFN-alpha and cytostatics, e.g. low-dose cytosine arabinoside.