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A new era for IFN-α in the treatment of Philadelphia-negative chronic myeloproliferative neoplasms.

Abstract

In recent years, several studies have shown that IFN-?2 is able to induce molecular remissions with undetectable JAK2V617F in a subset of patients with essential thrombocythemia (ET) and polycythemia vera (PV), even with normalization of the bone marrow and sustained molecular remissions after discontinuation of IFN-?2. Accordingly, interest in using IFN-?2 in the treatment of patients with PV and related neoplasms has been revived. This article highlights the current status of IFN-?2 in the treatment of patients with ET, PV, primary myelofibrosis and myelofibrosis following ET and PV. In the context of being able to induce ?minimal residual disease? in a subset of patients after long-term treatment with IFN-?2, the current risk-stratification systems used for treatment decisions are being challenged. It is argued that in 2011, the bulk of evidence for the efficacy and safety of pegylated interferons in treating patients with these neoplasms favors the upfront use of pegylated interferons, the goal being to influence the development of the disease at the molecular level and revert patients to a stage of ?minimal residual disease/operational cure? instead of progressive clonal evolution, genomic instability and leukemic or myelofibrotic transformation during long-term treatment with hydroxyurea.

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  • Publisher Full Text
  • Authors

    Hasselbalch HC

    Source

    Expert review of hematology 4:6 2011 Dec pg 637-55

    MeSH

    Antibodies, Neutralizing
    Antineoplastic Agents
    Autoimmune Diseases
    Bone Marrow
    Chromosome Aberrations
    Female
    Humans
    Interferon-alpha
    Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative
    Myeloproliferative Disorders
    Neoplasm, Residual
    Polycythemia Vera
    Pregnancy
    Primary Myelofibrosis
    Thrombocythemia, Essential

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22077528