Summary
Interferon alpha (α-IFN) is increasingly used for the treatment of patients affected by polycythemia vera (PV). As prior studies are difficult to interpret in view of the lack of appropriate controls, we undertook a randomized comparison of lymphoblastoid α-IFN (α n−1 IFN) treatment against venesection treatment alone. In a crossover trial, we treated 22 PV patients alternatively for 5 months each with 3 MU/day sc of α n−1 IFN and phlebotomy alone. During IFN treatment, red blood cell count and hematocrit level were well controlled in both trial groups, reducing or eliminating the need for phlebotomy in all patients; furthermore, platelet number and white blood cell count declined during α-IFN therapy. In addition, the number of symptomatic patients was greatly reduced, and in six patients a reduction in splenic size was observed. Finally, the only patient with chromosomal abnormalities showed a complete cytogenetic conversion after 5 months of α-IFN therapy. Thus, for the first time, our results provide the unequivocal demonstration that α-IFN is superior to phlebotomy in controlling the pathologic expansion of erythroid elements and all the clinical aspects of this disease.
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Berk PD, Goldberg JD, Donovan PB, Fruchtman SM, Berlin NI, Wasserman LR (1986) Therapeutic recommendations in Polycythemia Vera Study Group protocols. Semin Hematol 23:132
Cacciola E, Giustolisi R, Guglielmo P, Di Raimondo F, Cacciola E, Calogero RD (1991) Recombinant interferonα in the treatment of polycythemia vera. Blood 77:2790 (letter)
Cimino R, Rametta V, Matera C, Mele G, Mettivier V, Ferrara F (1993) Recombinant interferon α-2b in the treatment of polycythemia vera. Am J Hematol 44:155–157
Donovan PB, Kaplan ME, Goldberg JD et al. (1984) Treatment of polycythemia vera with hydroxyurea. Am J Hematol 17:329
Ellis JT, Peterson P, Geller SA, Rappaport H (1986) Studies of the bone marrow in polycythemia vera and evolution of myelofibrosis and second hematologic malignancies. Semin Hematol 23:144–155
Ferraris AM, Giuntini P, Galiano S, Gaetani GF (1981) 2-Deoxy-glucose-6-phosphate utilization in the study of glucose-6-phosphate dehydrogenase mosaicism. Hum Genet 33:307–313
Fialkow PJ (1980) Clonal and stem cell origin of blood cell neoplasms. In: Lobue J, Gordon AS, Silber R (eds) Contemporary hematology oncology. Plenum, New York, p 1
Hawkins TE, Carter JM, Romeril KR, Jackson SR, Green GJ (1993) Lymphoma transformation in polycythaemia vera treated with hydroxyurea. Am J Hematol 44:289–291
Hino M, Futami E, Okuno S, Miki T, Nishizawa Y, Morii H (1993) Possible selective effects of interferon α-2b on a malignant clone in a case of polycythemia vera. Ann Hematol 66:161–162
Landaw SA (1986) Acute leukemia in polycythemia vera. Semin Hematol 23:156–165
Messora C, Bensi L, Vecchi A, Longo R, Giacobbi F, Temperani P, Bevini M, Emilia G, Sacchi S (1994) Cytogenetic conversion in a case of polycythaemia vera treated with interferon-alpha. Br J Haematol 86:402–404
Nand S, Messmore H, Gross Fisher S, Bird ML, Schulz W, Fisher RI (1990) Leukemic transformation in polycythemia vera: analysis of risk factors. Am J Hematol 34:32–36
Papineschi F, Bucalossi A, Capochiani E, Vergamini P, Dispensa E, Benedetti E, Dastoli G, Spremolla G (1992) Recombinant interferon-alpha 2a for the treatment of polycythaemia vera: Fourier transform infrared microspectroscopy (FT-IR) study. (Abstract) 24th Congress of the International Society of Haematology, London, 23–27 August, p 135
Pearson TC (1987) Rheology of the absolute polycythaemias. Baillieres Clin Haematol 1:355–387
Raskind WH, Fialkow PJ (1987) The use of cell markers in the study of human hematopoietic neoplasia. In: Klein G, Weinhouse S (eds) Advances in cancer research. Academic, London, pp 127–167
Reiffers J, Dachary D, David B, Bernard P, Marit G, Boisseau M, Broustet A (1985) Megakaryoblastic transformation of primary thrombocythemia. Acta Haematol 73:228–231
Salem HH, Van Der Weyden MB, Young IF, Wiley DS (1982) Pruritus and severe iron deficiency in polycythaemia. Br Med J 285:91
Schimke RT, Sherwood SW, Hill AB, Johnston RN (1986) Overreplication and recombination of DNA in higher eukaryotes: potential consequences and biological implications. Proc Natl Acad Sci USA 83:2157–2161
Silver RT (1993) Interferon-a2b: a new treatment for polycythemia vera. Ann Intern Med 119:1091–1092
Taylor KMcD, Shetta M, Talpaz M, Kantarjian HM, Hardikar S, Chinault AC, McCredie KB, Spitzer G (1989) Myeloproliferative disorders: usefulness of X-linked probes in diagnosis. Leukemia 3:419–422
Tobelem G (1989) Essential thrombocythaemia. Baillierres Clin Haematol 2:3
Turri D, Mitra ME, Di Trapani R, Lipari MG, Perricone R, Cajozzo A (1991) Alpha-interferon in polycythemia vera and essential thrombocythemia. Haematologica (Pavia) 76:75–77
Van den Anker Lugtenburg PJ, Sizoo W (1990) Myelodysplastic syndromes and secondary acute leukemia after treatment of essential thrombocythemia with hydroxyurea. Am J Hematol 33:152
Vinti H, Taillan P, Pesce A, Michiels JF, Bajle J, Cassuto JP (1990) Megakaryoblastic transformation of essential thrombocythemia, hypercalcemia and litic bone lesions. Acta Haematol 83:53
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Sacchi, S., Leoni, P., Liberati, M. et al. A prospective comparison between treatment with phlebotomy alone and with interferon-alpha in patients with polycythemia vera. Ann Hematol 68, 247–250 (1994). https://doi.org/10.1007/BF01737425
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DOI: https://doi.org/10.1007/BF01737425