Effects of preemptive interferon-α monotherapy in acute leukemia patients with relapse tendency after allogeneic hematopoietic stem cell transplantation: a case-control study
Interferon-α (IFN-α) inhibits tumor growth and mimics graft-versus-leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the current case-control study, we compared treatment responses in acute leukemia patients with relapse tendency post-allo-HSCT receiving preemptive IFN-α after withdrawal of immunosuppressants (n = 31) vs. receiving no IFN-α (n = 67). In the IFN-α group, 25 patients responded to the treatment without progressing to hematological relapse. In the non-IFN-α group, only 22 patients responded to the treatment. The response rate differed significantly (80.6 vs. 32.8%, P < 0.001). The 2-year cumulative incidence of relapse was 31.6 and 61.2% in the IFN-α and the non-IFN groups, respectively (P = 0.006). The 2-year leukemia-free survival and overall survival rate was 57.4 vs. 28.4% (P < 0.001) and 67.6 vs. 32.9% (P = 0.001), respectively. Among the 31 patients in the IFN-α group, 18 patients (58.1%) developed graft-versus-host disease (GVHD): 6 acute and 12 limited chronic GVHD. Patients who developed GVHD had higher treatment response rate than patients without GVHD (88.9 vs. 53.8%, P = 0.022). In conclusion, preemptive IFN-α therapy is a safe and effective treatment to prevent disease progression in high-risk patients with relapse tendency post-allo-HSCT.
KeywordsAcute leukemia IFN-α Hematopoietic stem cell transplantation Recurrence Preemptive therapy
This work was supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), National Key R&D Program of China (2016YFC0902800), National Natural Science Foundation of China (81270645), NSFC Major Project of International Cooperation and Exchanges (81320108023), Frontier Clinical Technical Project Of the Science and Technology Department of Jiangsu Province (BE201765), and the Application of Basic Research Programs of Suzhou Municipal Science and Technology Project (SYS201457).
Compliance with ethical standards
Informed consent was obtained from patients in compliance with institutional guidelines. This study was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University.
Conflict of interest
The authors have no conflicts of interest to report.
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