Interferon alpha 2 maintenance therapy may enable high rates of treatment discontinuation in chronic myeloid leukemia
Interferon alpha 2 maintenance therapy may enable high rates of treatment discontinuation in chronic myeloid leukemia
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DOI：
10.1038/leu.2015.45
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发表时间：
2015-06-01
期刊：
影响因子：
11.4
通讯作者：
Hochhaus, A.
中科院分区：
文献类型：
--
作者：
Burchert, A.;Saussele, S.;Hochhaus, A.
少数慢性粒细胞白血病 (CML) 患者能够成功停用伊马替尼。目前尚不清楚增加这一比例的治疗方式。在此，我们评估了先前报道的 20 名慢性期 CML 患者队列中干扰素 α 2a (IFN) 对治疗中断的作用，这些患者预先接受 IFN α 加伊马替尼治疗，随后接受 IFN 单药治疗，以在伊马替尼停药后维持细胞遗传学或分子缓解 (MR)。中位随访 7.9 年（范围 5.2-12.2）后，在主要 MR (MMR) 和 MR4/MR4.5 中停用伊马替尼的患者的无复发生存率分别为 73%（8/11 名患者）和 84%（5/6 名患者）。 10 名患者在中位 4.5 年（范围，0.24-9.3）后停止使用 IFN。中位时间为 2.8 年（范围为 0.7-5.1）后，其中 9 人仍处于 MR5（n=6）和 MR4.5（n=3）的持续无治疗缓解状态。仍使用 IFN 的四名患者分别处于稳定 MR5、MR4.5、MR4 和 MMR。总之，IFN/伊马替尼诱导治疗后进行临时 IFN 维持治疗可能会使 CML 患者在停止伊马替尼时至少在 MMR 中实现较高的治疗终止率。
A minority of chronic myeloid leukemia (CML) patients is capable of successfully discontinuing imatinib. Treatment modalities to increase this proportion are currently unknown. Here, we assessed the role of interferon alpha 2a (IFN) on therapy discontinuation in a previously reported cohort of 20 chronic phase CML patients who were treated upfront with IFN alpha plus imatinib followed by IFN monotherapy to maintain cytogenetic or molecular remission (MR) after imatinib discontinuation. After a median follow-up of 7.9 years (range, 5.2-12.2), relapse-free survival was 73% (8/11 patients) and 84% (5/6 patients) for patients who discontinued imatinib in major MR (MMR) and MR4/MR4.5, respectively. Ten patients discontinued IFN after a median of 4.5 years (range, 0.24-9.3). After a median of 2.8 years (range, 0.7-5.1), nine of them remain in ongoing treatment-free remission with MR5 (n=6) and MR4.5 (n=3). The four patients who still administer IFN are in stable MR5, MR4.5, MR4, and MMR, respectively. In conclusion, an IFN/imatinib induction treatment followed by a temporary IFN maintenance therapy may enable a high rate of treatment discontinuation in CML patients in at least MMR when stopping imatinib.