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Interferon-α: A Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation.
Biol Blood Marrow Transplant. 2015 Nov; 21(11):1939-47.BB

Abstract

In this prospective clinical study, the safety and efficacy of preemptive interferon-α (IFN-α) treatment were investigated and compared with preemptive donor lymphocyte infusion (DLI) in patients who were minimal residual disease (MRD)-positive after allogeneic hematopoietic stem cell transplantation (HSCT). Patients undergoing allogeneic HSCT were eligible if they had acute leukemia or myelodysplastic syndrome and were MRD-positive after HSCT. Patients who were able to receive DLI were assigned to a preemptive DLI group (n = 45); patients who could not or did not agree to receive DLI after HSCT received preemptive IFN-α. A total of 22 patients received preemptive IFN-α; the median treatment duration was 35 days (range, 4 to 180 days). Seven patients relapsed, and 1 patient died from severe pneumonia. The 1-year cumulative incidence of chronic graft-versus-host disease (cGVHD) after intervention was 90.9% for the IFN-α group and 62.9% for the DLI group (P < .001). MRD status after preemptive intervention was comparable in the 2 groups, and the 1-year cumulative incidence of relapse after intervention was 27.3% for the IFN-α group and 35.6% for the DLI group (P = .514). The 1-year cumulative incidence of nonrelapse mortality after intervention was 4.5% for the IFN-α group and 4.4% for the DLI group (P = .985). The 1-year probability of disease-free survival after intervention was 68.2% for the IFN-α group and 60.0% for the DLI group (P = .517). In multivariate analysis, early-onset MRD, persistent MRD after intervention, and absence of cGVHD after intervention were significantly associated with poorer clinical outcomes. Thus, preemptive IFN-α may be a potential alternative for MRD-positive patients who cannot receive preemptive DLI after HSCT.

Authors+Show Affiliations

Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China.Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Electronic address: huangxiaojun@bjmu.edu.cn.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26116088

Citation

Mo, Xiao-Dong, et al. "Interferon-α: a Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 21, no. 11, 2015, pp. 1939-47.
Mo XD, Zhang XH, Xu LP, et al. Interferon-α: A Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(11):1939-47.
Mo, X. D., Zhang, X. H., Xu, L. P., Wang, Y., Yan, C. H., Chen, H., Chen, Y. H., Han, W., Wang, F. R., Wang, J. Z., Liu, K. Y., & Huang, X. J. (2015). Interferon-α: A Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 21(11), 1939-47. https://doi.org/10.1016/j.bbmt.2015.06.014
Mo XD, et al. Interferon-α: a Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(11):1939-47. PubMed PMID: 26116088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interferon-α: A Potentially Effective Treatment for Minimal Residual Disease in Acute Leukemia/Myelodysplastic Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation. AU - Mo,Xiao-Dong, AU - Zhang,Xiao-Hui, AU - Xu,Lan-Ping, AU - Wang,Yu, AU - Yan,Chen-Hua, AU - Chen,Huan, AU - Chen,Yu-Hong, AU - Han,Wei, AU - Wang,Feng-Rong, AU - Wang,Jing-Zhi, AU - Liu,Kai-Yan, AU - Huang,Xiao-Jun, Y1 - 2015/06/23/ PY - 2015/03/08/received PY - 2015/06/15/accepted PY - 2015/6/28/entrez PY - 2015/6/28/pubmed PY - 2016/7/21/medline KW - Donor lymphocyte infusion KW - Hematopoietic stem cell transplantation KW - IFN-α KW - Minimal residual disease KW - Preemptive SP - 1939 EP - 47 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 21 IS - 11 N2 - In this prospective clinical study, the safety and efficacy of preemptive interferon-α (IFN-α) treatment were investigated and compared with preemptive donor lymphocyte infusion (DLI) in patients who were minimal residual disease (MRD)-positive after allogeneic hematopoietic stem cell transplantation (HSCT). Patients undergoing allogeneic HSCT were eligible if they had acute leukemia or myelodysplastic syndrome and were MRD-positive after HSCT. Patients who were able to receive DLI were assigned to a preemptive DLI group (n = 45); patients who could not or did not agree to receive DLI after HSCT received preemptive IFN-α. A total of 22 patients received preemptive IFN-α; the median treatment duration was 35 days (range, 4 to 180 days). Seven patients relapsed, and 1 patient died from severe pneumonia. The 1-year cumulative incidence of chronic graft-versus-host disease (cGVHD) after intervention was 90.9% for the IFN-α group and 62.9% for the DLI group (P < .001). MRD status after preemptive intervention was comparable in the 2 groups, and the 1-year cumulative incidence of relapse after intervention was 27.3% for the IFN-α group and 35.6% for the DLI group (P = .514). The 1-year cumulative incidence of nonrelapse mortality after intervention was 4.5% for the IFN-α group and 4.4% for the DLI group (P = .985). The 1-year probability of disease-free survival after intervention was 68.2% for the IFN-α group and 60.0% for the DLI group (P = .517). In multivariate analysis, early-onset MRD, persistent MRD after intervention, and absence of cGVHD after intervention were significantly associated with poorer clinical outcomes. Thus, preemptive IFN-α may be a potential alternative for MRD-positive patients who cannot receive preemptive DLI after HSCT. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/26116088/Interferon_α:_A_Potentially_Effective_Treatment_for_Minimal_Residual_Disease_in_Acute_Leukemia/Myelodysplastic_Syndrome_after_Allogeneic_Hematopoietic_Stem_Cell_Transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(15)00416-4 DB - PRIME DP - Unbound Medicine ER -