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Use of Interferon-α in the Treatment of Chronic Myelogenous Leukemia

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Interferons
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Abstract

Chronic myelogenous leukemia (CML) is a clonal disease of hematopoietic stem cells [1]. It is characterized by an excessive increase in granulopoiesis and frequently also in megakaryopoiesis. The diagnostic criteria may vary slightly between authors and countries but in general include:

  1. 1.

    A leukocytosis of more than 30 × 109/l with a marked left shift

  2. 2.

    A hypercellular bone marrow characteristic of a myeloproliferative disease

  3. 3.

    Splenomegaly

  4. 4.

    Exclusion of a subacute leukemia or of myelodysplasia

  5. 5.

    Exclusion of other myeloproliferative diseases such as osteomyelofibrosis, essential thrombocythemia or polycythemia vera

  6. 6.

    The demonstration of the Philadelphia (Ph) chromosome or bcr/abl translocation

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References

  1. Beutler E, Lichtman MA, Coller BS, Kipps TJ (eds) (1995) Williams Hematology, 5th ed. McGraw-Hill, New York, pp 298–324

    Google Scholar 

  2. Hehlmann R, Heimpel H, Hasford J et al (1994) Randomized comparison of interferon-alpha with busulfan and hydroxyurea in chronic myelogenous leukemia (CML). Blood 84: 4064–4077

    PubMed  CAS  Google Scholar 

  3. Sokal JE, Cox EB, Baccarani M et al (1984) Prognostic discrimination in “good-risk” chronic granulocytic leukemia. Blood 63: 789–799

    PubMed  CAS  Google Scholar 

  4. Sokal JE, Baccarani M, Tura S et al (1985) Prognostic discrimination among younger patients with chronic granulocytic leukemia: relevance to bone marrow transplantation. Blood 66: 1352–1357

    PubMed  CAS  Google Scholar 

  5. Hehlmann R, Heimpel H, Kolb HJ et al (1993) The German CML-Study. Comparison of busulfan vs. hydroxyurea vs. interferon alpha and establishment of prognostic score 1. Leuk Lymphoma 11(Suppl 1): 159–168

    Article  PubMed  Google Scholar 

  6. The Italian Cooperative Study Group on Chronic Myeloid Leukemia (1994) Interferon alfa-2a as compared with conventional chemotherapy for the treatment of chronic myeloid leukemia. N Engl J Med 330: 820–825

    Article  Google Scholar 

  7. Allan NC, Richards SM, Shepherd PCA (1995) UK Medical Research Council randomized, multicentre trial of interferon-αn1 for chronic myeloid leukaemia is not confined to patients with cytogenetic response: improved survival irrespective of cytogenetic response. Lancet 345: 1392–1397

    Article  PubMed  CAS  Google Scholar 

  8. Ohnishi K, Ohno R, Tomonsga M et al (1995) A randomized trial comparing interferon-a with busulfan for newly diagnosed chronic myelogenous leukemia in chronic phase. Blood 86: 906–916

    PubMed  CAS  Google Scholar 

  9. Kantarjian HM, Smith TL, O’Brien S, Beran M, Pierce S, Talpaz M (1995) Prolonged survival in chronic myelogenous leukemia following cytogenetic response to alpha interferon therapy. Ann Intern Med 122: 254–261

    PubMed  CAS  Google Scholar 

  10. Tanzer J, Guilhot F, and the German CML Study Group (1996) Standardization of clinical and investigatory practice (to be published)

    Google Scholar 

  11. Hehlmann R, Heimpel H, Hasford J et al (1993) Randomized comparison of busulfan and hydroxyurea in chronic myelogenous leukemia (CML): prolongation of survival by hydroxyurea. Blood 82: 398–407

    PubMed  CAS  Google Scholar 

  12. Mahon FX, Montastruc M, Faberes C, Reiffers J (1994) Predicting complete cytogenetic response in chronic myelogenous leukemia patients treated with recombinant interferon-α. Blood 84: 3592–3594

    PubMed  CAS  Google Scholar 

  13. Hehlmann R, Heimpel H, Hasford J and the German CML Study Group (1995) Randomized comparison of interferon alpha, hydroxyurea and busulfan in CML. Blood 85: 3000–3002

    CAS  Google Scholar 

  14. Talpaz M, Kantarjian HM, McCredie K, Trujillo JM, Keating MJ, Gutterman JU (1986) Hematologic remission and cytogenetic improvement induced by recombinant human interferon alpha in chronic myelogenous leukemia. N Engl J Med 314: 1065–1069

    Article  PubMed  CAS  Google Scholar 

  15. Thomas ED, Clift RA (1989) Indications for marrow transplantation in chronic myelogenous leukemia. Blood 73: 861–864

    PubMed  CAS  Google Scholar 

  16. Armitage JO (1994) Bone marrow transplantation. N Engl J Med 330: 827–838

    Article  PubMed  CAS  Google Scholar 

  17. Minot GR, Buckman TE, Isaacs R (1924) Chronic myelogenous leukemia. Age, incidence, duration and benefit derived from treatment. JAMA 82: 1489–1494

    Google Scholar 

  18. Medical Research Council’s Working Party for Therapeutic Trials in Leukemia: Chronic granulocytic leukemia: comparison of radiotherapy and busulfan therapy. Br Med J1: 201–208

    Google Scholar 

  19. Hehlmann R, Heimpel H (1996) Current aspects of drug therapy in Philadelphia-positive CML: correlation of tumor burden with survival. Leuk Lymphoma (in press)

    Google Scholar 

  20. Haut A, Abbott WS, Wintrobe MM, Cartwright GE (1961) Busulfan in the treatment of chronic myelocytic leukemia: the effect of long term intermittent therapy. Blood 17: 1–19

    PubMed  CAS  Google Scholar 

  21. Galton DAG (1969) Chemotherapy of chronic myelocytic leukemia. Semin Hematol 6: 323–343

    PubMed  CAS  Google Scholar 

  22. Müller L, Hehlmann R (1987) 24 Jahre Überlebenszeit bei chronisch myeloischer Leukämie. Klin Wochenschr 65: 673–676

    Article  PubMed  Google Scholar 

  23. Brodsky I, Fuscaldo KE, Kahn SB, Conroy JF (1979) Myeloproliferative disorders. II. CML: clonal evolution and its role in management. Leuk Res 3: 379–393

    Article  PubMed  CAS  Google Scholar 

  24. Cunningham I, Gee T, Dowling M et al (1979) Results of treatment of Ph1+ chronic myelogenous leukemia with an intensive treatment regimen (L-5 protocol). Blood 53: 375–395

    PubMed  CAS  Google Scholar 

  25. Baccarani M, Corbelli G, Tura S, and the Italian Cooperative Study Group on Chronic Myeloid Leukemia (1981) Early splenectomy versus polychemotherapy alone in chronic myeloid leukemia. Leuk Res 5: 149–157

    Article  PubMed  CAS  Google Scholar 

  26. Tura S, Zaccaria A, Corbelli G et al (1984) Results of a prospective randomized trial of early splenectomy in chronic myeloid leukemia. Cancer 54: 333–338

    Article  Google Scholar 

  27. Kantarjian HM.Vellekoop L, McCredie KB et al (1985) Intensive combination chemotherapy (ROAP 10) and splenectomy in the management of chronic myelogenous leukemia. J Clin Oncol 3: 192–200

    PubMed  CAS  Google Scholar 

  28. Kantarjian HM, Talpaz M, Kurzrock R et al (1987) Intensive combination chemotherapy and interferons in the management of chronic myelogenous leukemia. Acta haematol 78 (Suppl 1): 70–74

    Article  PubMed  Google Scholar 

  29. Smalley RV, Vogel J, Huguley CM, JUR, Miller D (1977) Chronic granulocytic leukemia: cytogenetic conversion of the bone marrow with cycle-specific chemotherapy. Blood 150: 107–113

    Google Scholar 

  30. Allan NC, Ducall E, Stockdill G (1978) Combination chemotherapy for chronic granulocytic leukemia. Lancet 2: 523

    Article  PubMed  CAS  Google Scholar 

  31. Goto T, Nishikori M, Arlin Z et al (1982) Growth characteristics of leukemic and normal hematopoietic cells in Ph1+ chronic myologenous leukemia and effects of intensive treatment. Blood 59: 793–808

    PubMed  CAS  Google Scholar 

  32. Sharp JC, Joyner MV, Wayne AW et al (1979) Karyotypic conversion in Ph-1-positive chronic myeloid leukemia with combination chemotherapy. Lancet 1: 1370–1372

    Article  PubMed  CAS  Google Scholar 

  33. Hehlmann R (1988) Cytostatic therapy in chronic myelogenous leukemia: review and perspectives. In: Huhn D, Hellriegel KP, Niederle N (eds) Chronic myelocytic leukemia and interferon. Springer, Berlin Heidelberg New York, pp 102–112

    Google Scholar 

  34. Kennedy BJ (1972) Hydroxyurea therapy in chronic myelogenous leukemia. Cancer 29: 1052–1056

    Article  PubMed  CAS  Google Scholar 

  35. Bolin RW, Robinson WA, Sutherland J, Hamman RF (1982) Busulfan versus hydroxyurea in long-term therapy of chronic myelogenous leukemia. Cancer 50: 1683–1687

    Article  PubMed  CAS  Google Scholar 

  36. Rushing D, Goldman A, Gibb G, Howe R, Kennedy BJ (1982) Hydroxyurea versus busulfan in the treatment of chronic myelogenous leukemia. Am J Clin Oncol Cancer Clin Trials 5: 307–313

    CAS  Google Scholar 

  37. Talpaz M, McCredie K, Mavligit GM, Gutterman JU (1983) Leukocyte interferon-induced myeloid cytoreduction in chronic myelogenous leukemia. Blood 62: 689–692

    PubMed  CAS  Google Scholar 

  38. Aman MJ, Rudolf G, Goldschmitt J et al (1993) Type-I interferons are potent inhibitors of interleukin- 8 production in hematopoietic and bone marrow stromal cells. Blood 82: 2371–2378

    PubMed  CAS  Google Scholar 

  39. Aulitzky WE, Peschel C, Schneller F, Huber C (1995) Biotherapy of chronic myelogenous leukemia. Ann Hematol 70: 113–120

    Article  PubMed  CAS  Google Scholar 

  40. Lengyel P (1993) Tumor-suppressor genes: news about the interferon connection. Proc Natl Acad Sci USA 90: 5893–5895

    Article  PubMed  CAS  Google Scholar 

  41. Fu XY (1992) A transcription factor with SH2 and SH3 domains is directly activated by an interferon-α-induced cytoplasmic protein tyrosine kinase (s). Cell 70: 323–335

    Article  PubMed  CAS  Google Scholar 

  42. Müller M, Briscoe J, Laxton C et al (1993) The protein tyrosine kinase JAK1 complements defects in interferon α/β and -γ signal transduction. Nature 366: 129

    Article  PubMed  Google Scholar 

  43. Talpaz M, Kantarjian W, Kurzrock R, Trujillo JM, Gutterman JU (1991) Interferon alpha produces sustained cytogenetic responses in chronic myelogenous leukemia. Ann Intern Med 114: 532–538

    PubMed  CAS  Google Scholar 

  44. Ozer H, George SL, Schiffer CA et al (1993) Prolonged subcutaneous administration of recombinant a2b interferon in patients with previously untreated Philadelphia chromosome-positive chronic-phase chronic myelogenous leukemia: effect on remission duration and survival: cancer and leukemia group B study 8583. Blood 82: 2975–2984

    PubMed  CAS  Google Scholar 

  45. Niederle N, Kloke O, Doberauer C, Becher R, Beelen DW, Schmidt CG (1986) Alpha-2-Interferon-Erste Behandlungsergebnisse bei der chronischen myeloischen Leukämie. Dtsch Med Wochenschr 111: 765–767

    Article  Google Scholar 

  46. Alimena B, Morra E, Lazzarino M et al (1988) Interferon alpha-2b as therapy for Ph′-positive chronic myelogenous leukemia: a study of 82 patients treated with intermittent or daily administration. Blood 72: 642–647

    PubMed  CAS  Google Scholar 

  47. Kloke 0, Niederle N, Qiu JY et al (1993) Impact of interferon alpha-induced cytogenetic improvement on survival in chronic myelogenous leukaemia. Br J Haematol 83: 399–403

    Article  PubMed  CAS  Google Scholar 

  48. Thaler J, Kühr T, Gastl G et al (1991) Rekombinantes Interferon α-2c bei Ph-positiver chronischer myeloischer Leukämie. Ergebnisse einer multizentrischen Phase-II-Studie. Dtsch Med Wochenschr 16: 721–728

    Article  Google Scholar 

  49. Guilhot J, Abgrall JF, Harousseau JL et al (1993) A multicentric randomised study of alpha 2b interferon (IFN) and hydroxyurea (HU) with or without cytosine-arabinoside (ara-c) in previously untreated patients with Ph+ chronic myelocytic leukemia (CML): preliminary cytogenetic results. Leuk Lymphoma 11: 181–183

    Article  PubMed  Google Scholar 

  50. Griesshammer M, Hehlmann R, Hochhaus A et al (1993) Interferon in chronic myelogenous leukemia. A workshop report. Ann Hematol 67: 101–106

    CAS  Google Scholar 

  51. Hehlmann R (1996) Does interferon alpha prolong life? Leukemia 10: 193–196

    PubMed  CAS  Google Scholar 

  52. Roth MS, Antin JH, Ash R et al (1992) Prognostic significance of Philadelphia chromosome-positive cells detected by the polymerase chain reaction after allogeneic bone marrow transplant for chronic myelogenous leukemia. Blood 79: 276–282

    PubMed  CAS  Google Scholar 

  53. Miyamura K, Tahara T, Tanimoto M et al (1993) Long persistent bcr-abl positive transcript detected by polymerase chain reaction after marrow transplant for chronic myelogenous leukemia without clinical relapse: a study of 64 patients. Blood 81: 1089–1093

    PubMed  CAS  Google Scholar 

  54. Cross NCP, Feng L, Bungey J, Goldman JM (1993) Minimal residual disease after bone marrow transplant for chronic myeloid leukaemia detected by the polymerase chain reection. Leuk Lymphoma 11: 39–43

    Article  PubMed  Google Scholar 

  55. Radich JP, Gehly G, Gooley T et al (1995) Polymerase chain reaction detection of the BCR-ABL fusion transcript after allogeneic marrow transplantation for chronic myeloid leukemia: results and implications in 346 patients. Blood 85: 2632–2638

    PubMed  CAS  Google Scholar 

  56. Cross NCP, Feng L, Chase A, Bungey J, Hughes TP, Goldman JM (1993) Competitive polymerase chain reaction to estimate the number of BCR-ABL transcripts in chronic myeloid leukemia patients after bone marrow transplantation. Blood 82: 1929–1936

    PubMed  CAS  Google Scholar 

  57. Lee MS, Kantarjian H, Talpaz M et al (1992) Detection of minimal residual disease by polymerase chain reaction in Philadelphia chromosome-positive chronic myelogenous leukemia following interferon therapy. Blood 79: 1920–1923

    PubMed  CAS  Google Scholar 

  58. Opalka B, Wandl UB, Becher R et al (1991) Minimal residual disease in patients with chronic myelogenous leukemia undergoing long-term treatment with recombinant interferon α-2b alone or in combination with interferon γ. Blood 78: 2188–2193

    PubMed  CAS  Google Scholar 

  59. Malinge MC, Mahon FX, Delfau MH et al (1993) Quantitative determination of the hybrid bcr-abl RNA in patients with chronic myelogenous leukaemia under interferon therapy. Br J Haematol 82: 701–707

    Article  Google Scholar 

  60. Hochhaus A, Lin F, Reiter A et al (1995) Variable numbers of BCR-ABL transcripts persist in CML patients who achieve complete cytogenetic remission with interferon-α. Br J Haematol 91: 126–131

    Article  PubMed  CAS  Google Scholar 

  61. Oguma N, Shigeta C, Takauchi K et al (1992) Molecular elimination of the minimal residual Ph1 clone with IFNα in CML. Lancet 339: 557–558

    Article  PubMed  CAS  Google Scholar 

  62. Biernaux C, Loos M, Sels A, Huez G, Strykmanms P (1995) Detection of major BCR-ABL gene expression at a very low level in blood cells of some healthy individuals. Blood 86: 3118–3122

    PubMed  CAS  Google Scholar 

  63. Verschreegen CF, Talpaz M, Hirsch-Ginsberg C et al (1995) Quantification of the breakpoint cluster region rearrangement for clinical monitoring in Philadelphia chromosome-positive chronic myeloid leukemia. Blood 85: 2705–2710

    Google Scholar 

  64. Reiter A, Skladny H, Hochhaus A, Hehlmann R (1995) Molecular monitoring of patients with chronic myelogenous leukemia on interferon-α therapy by quantitative Southern blot. Exp Hematol 23: 792

    Google Scholar 

  65. Freund M, von Wussow P, Diedrich H et al (1989) Recombinant human interferon (IFN) alpha-2b in chronic myelogenous leukemia-dose dependency of response and frequency of neutralizing anti-interferon antibodies. Br J Haematol 72: 350

    Article  PubMed  CAS  Google Scholar 

  66. Wussow PV, Jakschies D, Freund M et al (1991) Treatment of antirecombinant interferon-alpha 2 antibody positive CML patients with natural interferon-alpha. Br J Haematol 78: 210

    Article  PubMed  CAS  Google Scholar 

  67. Kantarjian HM, Talpaz M, Keating MJ et al (1991) Intensive chemotherapy induction followed by interferon-alpha maintenance in patients with Philadelphia chromosome-positive chronic myelogenous leukemia. Cancer 68: 1201–1207

    Article  PubMed  CAS  Google Scholar 

  68. Hoyle C, Gray, R, Goldman J (1994) Autografting for patients with CML in chronic phase: an update. Br J Haematol 86: 76–81

    Article  PubMed  CAS  Google Scholar 

  69. Simonsson B, Oberg G, Kiliander A et al (1993) Intensive treatment in order to minimize the Ph-positive clone in chronic myelogenic leukemia. Stem Cells 11 (Suppl 3): 73–76

    Article  PubMed  Google Scholar 

  70. Carella AM, Podesta M, Frassoni F et al (1993) Collection of “normal” blood repopulating cells during early hemopoietic recovery after intensive conventional chemotherapy in chronic myelogenous leukemia. Bone Marrow Transplant 12: 267–271

    PubMed  CAS  Google Scholar 

  71. McGlave PB, De Fabritiis P, Deisseroth A et al (1994) Autologous transplants for chronic myelogenous leukaemia: results from eight transplant groups. Lancet 343: 1486–1488

    Article  PubMed  CAS  Google Scholar 

  72. Gale RP, Baccarani M, Horowitz MM, Zhang MJ (1993) Is the course of chronic myelogenous leukemia affected by bone marrow transplantation? An analysis in patients relapsing after bone marrow transplants. Blood 92 (Suppl 1): 167a

    Google Scholar 

  73. Clift RA, Applebaum FR, Thomas ED (1994) Bone marrow transplantation for chronic myelogenous leukemia. Blood 83: 2752–2753

    Google Scholar 

  74. Gratwohl A, Hermans J, v.Biezen A et al (1992) No advantage for patients who receive splenic irradiation before bone marrow transplantation for chronic myeloid leukaemia: results of a prospective randomized study. Bone Marrow Transplant 10: 147–152

    PubMed  CAS  Google Scholar 

  75. Beatty PG, Anasetti C, Hansen JA et (1993) Marrow transplantation from unrelated donors for treatment of hematologic malignancies: effects of mismatching for one HLA locus. Blood 81: 249–253

    PubMed  CAS  Google Scholar 

  76. Kernan NA, Bartsch G, Ash RC (1993) Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program. N Engl J Med 328: 593–602

    Article  PubMed  CAS  Google Scholar 

  77. Goldman JM, Gale RP, Horowitz MM et al (1988) Bone marrow transplantation for chronic myelogenous leukemia in chronic phase. Ann Intern Med 108: 806–814

    PubMed  CAS  Google Scholar 

  78. Horowitz MM, Gale RP, Sondel PM et al (1990) Graft-versus-leukemia reactions after bone marrow transplantation. Blood 75: 555–562

    PubMed  CAS  Google Scholar 

  79. Goldman J (1995) Peripheral blood stem cells for allografting. Blood 85: 1413–1415

    PubMed  CAS  Google Scholar 

  80. Schmitz N, Dreger P, Suttorp M et al (1995) Primary transplantation of allogeneic peripheral blood progenitor cells mobilized by filgrastim (granulocyte colony-stimulating factor). Blood 85: 1666–1772

    PubMed  CAS  Google Scholar 

  81. Körbling M, Przepiorka D, Huh YO et al (1995) Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantage of blood over marrow allografts. Blood 85: 1659–1665

    PubMed  Google Scholar 

  82. Bensinger WI, Weaver CH, Applebaum FR et al (1995) Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor. Blood 85: 1655–1658

    PubMed  CAS  Google Scholar 

  83. Kolb HJ, Mittermüller J, Clemm C et al (1990) Donor leukocyte transfusions for treatment of recurrent chronic myelogenous leukemia in marrow transplant patients. Blood 76: 2462–2465

    PubMed  CAS  Google Scholar 

  84. Goldman JM, Szydlo R, Horowitz MM et al (1993) Choice of pretransplant treatment and timing of transplants for chronic myelogenous leukemia in chronic phase. Blood 82: 2235–2238

    PubMed  CAS  Google Scholar 

  85. Giralt SA, Kantarjian HM, Talpaz M et al (1993) Effect of prior interferon alfa therapy on the outcome of allogeneic bone marrow transplantation for chronic myelogenous leukemia. J Clin Oncol 11: 1055–106

    PubMed  CAS  Google Scholar 

  86. Beelen DW, Graeven U, Elmaagacli AH et al (1995) Prolonged administration of interferon-α in patients with chronic phase Philadelphia chromosome-positive chronic myelogenous leukemia before allogeneic bone marrow transplantation may adversely affect transplant outcome. Blood 85: 2981–2990

    PubMed  CAS  Google Scholar 

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Hehlmann, R., Reiter, A. (1997). Use of Interferon-α in the Treatment of Chronic Myelogenous Leukemia. In: Aul, C., Schneider, W. (eds) Interferons. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60411-9_5

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  • DOI: https://doi.org/10.1007/978-3-642-60411-9_5

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