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Incidence of response and long-term follow-up in patients with hairy cell
leukemia treated with recombinant interferon alfa-2a [see comments]
E Berman, G Heller, S Kempin, T Gee, LL Tran and B Clarkson
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York,
NY 10021.
Thirty-five evaluable patients with hairy cell leukemia (HCL) were treated
with recombinant interferon alfa-2a (rIFN-alpha 2a), given at a dose of 3 X
10(6) units (U) intramuscularly (IM) daily for 6 months followed by 3 X
10(6) U IM three times a week for an additional 18 months in a single
institution study. All treatment was stopped after 24 months. Sixty-nine
percent of patients achieved a partial response, 11% a minor response, and
3% (one patient) had stable disease. Six patients (17%) did not respond to
rIFN-alpha 2a. Two patients (6%) achieved a response but later progressed
on treatment. A total of 23 patients completed 2 years of treatment and are
evaluable for long-term follow-up at a median of 20 months postcompletion
of therapy (range 9 to 32 months). Eleven patients (48%) have had
progression of their disease at a median of 10 months (range .5 to 25
months) after treatment was discontinued. Statistical analysis of
pretreatment patient characteristics did not reveal any factor(s)
associated with a high probability of responding to rIFN-alpha 2a; however,
analysis of post-treatment variables measured after 2 years of treatment
suggested that a low platelet count was associated with a high rate of
disease progression. These findings are compared with other published
trials using rIFN-alpha 2b, a similar but not identical rIFN preparation.
We conclude that while rIFN-alpha 2a has a high overall response incidence,
the rate of disease progression after therapy is discontinued approaches
50%, and that a subset of patients can be identified who are at high risk
for recurrence after completing 2 years of treatment.
Volume 75,
Issue 4,
pp. 839-845,
02/15/1990
Copyright © 1990 by The American Society of Hematology
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