Preemptive Interferon-α Therapy Could Protect Against Relapse and Improve Survival of Acute Myeloid Leukemia Patients After Allogeneic Hematopoietic Stem Cell Transplantation: Long-Term Results of Two Registry Studies

• Published in: Frontiers in immunology 2022-01, Vol.13, p.757002
• Main Authors: Shen, Meng-Zhu, Zhang, Xiao-Hui, Xu, Lan-Ping, Wang, Yu, Yan, Chen-Hua, Chen, Huan, Chen, Yu-Hong, Han, Wei, Wang, Feng-Rong, Wang, Jing-Zhi, Zhao, Xiao-Su, Qin, Ya-Zhen, Chang, Ying-Jun, Liu, Kai-Yan, Huang, Xiao-Jun, Mo, Xiao-Dong
• Format: Article
• Language: English
• Subjects: acute myeloid leukemia; Adolescent; Adult; Aged; Child; Disease-Free Survival; Female; Follow-Up Studies; Graft vs Host Disease - etiology; Graft vs Host Disease - prevention & control; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunologic Factors - administration & dosage; Immunology; Injections, Subcutaneous; Interferon alpha-2 - administration & dosage; interferon-α; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Male; Middle Aged; minimal residual disease; Neoplasm, Residual; preemptive; Prospective Studies; Recurrence; Registries; Secondary Prevention - methods; Transplantation Conditioning - methods; Transplantation, Homologous - adverse effects; Young Adult
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2022.757002

For allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, preemptive interferon-α (IFN-α) therapy is considered as a useful method to eliminate the minimal residual disease (MRD). Our purpose is to assess the long-term efficacy of preemptive IFN-α therapy in acute myeloid leukemia (AML) patients following allo-HSCT based on two registry studies (#NCT02185261 and #NCT02027064). We would present the final data and unpublished results of long-term clinical outcomes with extended follow-up. We adopted polymerase chain reaction (PCR) and multiparameter flow cytometry (MFC) to monitor MRD, and a positive result of bone marrow specimen examined by either of them would be identified as the MRD-positive status. Subcutaneous injections of recombinant human IFN-α-2b were performed for 6 cycles, and prolonged IFN-α therapy could be permitted at the request of patients. The median cycles were 3.5 (range, 0.5-30.5) cycles. A total of 9 patients suffered from grade ≥3 toxicities (i.e., infectious: n = 6; hematologic: n = 3). The 6-year cumulative incidences of relapse and non-relapse mortality following IFN-α therapy were 13.0% (95% confidence interval [CI], 5.4-20.6%) and 3.9% (95%CI, 0.0-17.6%), respectively. The probability of disease-free survival at 6 years following IFN-α therapy was 83.1% (95%CI, 75.2-91.9%). The probability of overall survival at 6 years following IFN-α therapy was 88.3% (95%CI, 81.4-95.8%). The cumulative incidences of total chronic graft-versus-host disease (cGVHD) and severe cGVHD at 6 years following IFN-α therapy were 66.2% (95%CI, 55.5-77.0%) and 10.4% (95%CI, 3.6-17.2%), respectively. Multivariable analysis showed that an alternative donor was associated with a lower risk of relapse and the better disease-free survival. Thus, preemptive IFN-α therapy could clear MRD persistently, prevent relapse truly, and improve long-term survival in AML patients following allo-HSCT.