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Therapy

Alpha-interferon improves survival and remission duration in P-190BCR-ABL positive adult acute lymphoblastic leukemia

Leukemia volume 14, pages 22–27 (2000)Cite this article

Abstract

Treatment of P190BCR-ABL+ acute lymphoblastic leukemia (ALL) patients remains problematic: one possibility is to use biologic response modifiers such as α-interferon (α-IFN), which is known to be active in chronic myeloid leukemia (CML). We used α-IFN to treat 10 adult P190BCR-ABL+ ALL patients (eight newly diagnosed; two in first relapse). All received a remission induction chemotherapy (modified L-20 protocol). Patients achieving morphological, immunological and cytogenetic complete remission (CR) were then submitted to a rotational consolidation regimen lasting 6 months. When no HLA-identical donor was available, patients aged <55 years underwent stem cell harvest followed by autologous transplantation; patients aged ⩾55 years received standard maintenance treatment for 6 months. In the second year, maintenance treatment (all ages) was based on cycles of α-IFN (3 mu three times a week for 6 weeks) alternated with methotrexate/6-mercaptopurine continuously for up to 2 years from first demonstration of CR. Thereafter, patients maintaining CR had the same schedule of α-IFN (6 weeks on, 6 off). Eight patients (6/8 first diagnosis, 2/2 relapsed) obtained morphological, immunological and cytogenetic CR with persistent molecular positivity. Two with an HLA-identical donor had allogeneic bone marrow transplantation. Six proceeded with chemotherapy: one experienced early relapse, three were autotransplanted, and two received maintenance. Five patients then received α-IFN as scheduled. All five are in continuous morphological and cytogenetic CR, with a longer mean duration of maintained morphological CR (mean 46 months; range: 20–88) than in previous reports of Ph+ ALL patients treated with chemotherapy regimens (excluding allogeneic BMT). α-IFN thus appears effective in this poor-risk subset of patients. This well-tolerated IFN-containing maintenance treatment could be considered to reinforce intensified programs based on autologous stem cell transplantation as an alternative to allogeneic transplantation in p190BCR-ABL+ ALL patients (and by extension for Ph+ ALL patients) lacking an HLA-matched donor.

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Acknowledgements

This work was supported in part by MURST.

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  1. Institute of Hematology and Medical Oncology ‘Seragnoli’, University of Bologna, Bologna, Italy

    G Visani, G Martinelli, P Piccaluga, P Tosi, M Amabile, R Pastano, M Cavo, A Isidori & S Tura

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Visani, G., Martinelli, G., Piccaluga, P. et al. Alpha-interferon improves survival and remission duration in P-190BCR-ABL positive adult acute lymphoblastic leukemia. Leukemia 14, 22–27 (2000). https://doi.org/10.1038/sj.leu.2401641

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