[Use of interferon alpha in multiple myeloma]

Alpha Interferon has been used for fifteen years in the management of patients with multiple myeloma. However this indication remains controversial. Seven multicenter randomized trials have compared alpha Interferon with observation in patients responding to conventional chemotherapy. Three of these studies have given negative results. In the other four, alpha Interferon therapy has prolonged remission duration but in none of them has the overall survival been significantly prolonged. After intensive treatments the results of only one study are available and are in favour of alpha Interferon. Seven randomized studies have tested the impact of a combination chemotherapy plus alpha Interferon as compared to chemotherapy alone. Only one has shown a significant benefit for patients receiving chemotherapy plus natural alpha Interferon. This benefit has been limited of IgA and BJ myelomas and to stage II myelomas. Finally, the combination high dose dexamethasone-alpha Interferon has given promising preliminary results which justify prospective ongoing studies. These clinical results are analyzed in relation to the in vitro data.