Multicenter prospective study of interferon-α versus bone marrow transplantation for newly diagnosed patients with chronic myelogenous leukemia : a preliminary analysis

• Published in: Cancer chemotherapy and pharmacology 2001-08, Vol.48, p.S59-S64
• Main Authors: OHNISHI, Kazunori, INO, Teruo, OHNO, Ryuzo, KISHIMOTO, Yuji, USUI, Noriko, SHIMAZAKI, Chihiro, OHTAKE, Shigeki, TAGUCHI, Hirokuni, KUSUMOTO, Shuya, KURIYAMA, Kazutaka, HOTTA, Tomomitsu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic agents; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bone Marrow Transplantation; Female; Follow-Up Studies; Humans; Hydroxyurea - administration & dosage; Immunotherapy; Interferon-alpha - administration & dosage; Interferon-alpha - therapeutic use; Leukemia, Myeloid, Chronic-Phase - drug therapy; Leukemia, Myeloid, Chronic-Phase - therapy; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prospective Studies; Survival Rate
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s002800100307

Interferon-alpha (IFN-alpha) therapy was compared with bone marrow transplantation (BMT) in patients with chronic myelogenous leukemia (CML) in a multicenter, prospective study. Of 254 evaluable patients, 175 received IFN-alpha and 79 received allogeneic BMT, 50 of whom received transplants from human leukocyte antigen (HLA)-identical related donors and 29 from HLA-matched unrelated donors. Complete hematologic response was achieved by 148 patients (89%) in the IFN-alpha group and 53 (78%) in the BMT group. In the IFN-alpha group, a complete cytogenetic response was induced in 25 patients (15%), a partial cytogenetic response in 37 (23%), and a minor cytogenetic response in 41 (25%). At a median follow-up of 38 months, in the IFN-alpha group the predicted 5-year survival rate was 79%, and the predicted 5-year rate of remaining in chronic phase was 66%. In the BMT group the predicted 5-year survival rate was 72% for related-donor BMT and 67% for unrelated-donor BMT. Among low Sokal-risk patients, 5-year survival did not differ between IFN-alpha therapy and BMT, irrespective of age. In higher Sokal-risk patients, survival for related-donor BMT and unrelated-donor BMT tended to be better than that with IFN-alpha therapy in younger patients. On the other hand, in older patients, survival in the BMT group, especially for those receiving unrelated-donor BMT, appeared to be inferior to that in the IFN-alpha group. Unrelated-donor BMT can be recommended for high-risk younger patients. However, for older patients, it should be performed after careful consideration of prognostic factors such as age, Sokal score, and response to IFN-alpha.