INTERFERON-ALPHA PRODUCES SUSTAINED CYTOGENETIC RESPONSES IN CHRONIC MYELOGENOUS LEUKEMIA - PHILADELPHIA CHROMOSOME-POSITIVE PATIENTS

Objectives: To evaluate the frequency and the course of complete cytogenetic responses in interferon-alpha (IFN-alpha)-treated patients with chronic myelogenous leukemia. Design: Two prospective trials in consecutive patients. Setting: A major tertiary cancer center. Patients: Ninety-six consecutive patients with chronic myelogenous leukemia with disease duration of less than 1 year. Intervention: Patients received partially pure IFN-alpha intramuscularly, from 3 to 9 million U/d (51 patients) or recombinant IFN-alpha-2a (Roferon, Hoffmann-LaRoche, Inc., Nutley, New Jersey), 5 million U/m2 body surface area daily (45 patients). Measurements: Hematologic and cytogenetic tests were administered. Main Results: Seventy of the patients (73%) achieved hematologic remission (95% CI, 63% to 81%), and 18 (19%) had complete suppression of the Philadelphia chromosome on at least one cytogenetic test. A complete cytogenetic response was induced in 7 of 51 or 14% (CI, 6% to 26%) of the patients treated with the partially pure IFN-alpha and in 11 of 45 or 24% (CI, 13% to 40%) of the patients treated with recombinant IFN-alpha-2a. The difference in complete cytogenetic response between the two groups was 10.7% (CI, -5% to 26%; P > 0.2). Eleven patients had durable, ongoing, complete cytogenetic responses from 6 to more than 45 months (median, more than 30 months). Conclusion: This study was the first to show sustained, complete cytogenetic responses in a subset of patients with chronic myelogenous leukemia treated with single-agent therapy. The nature of this remission, that is, whether it depends on continuous therapy, requires further study.