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Recurrence of clonal hematopoiesis after discontinuing pegylated recombinant interferon-α 2a in a patient with polycythemia vera

Leukemia volume 21, pages 373–374 (2007)Cite this article

Patients with polycythemia vera (PV) are most often treated with phlebotomy and low-dose aspirin therapy alone. Chemotherapeutic agents including hydroxyurea are frequently utilized in patients who are at a high risk of developing thromboses or have disease related systemic symptoms. Such treatment options are unsatisfactory due to the persistent susceptibility of patients to thrombosis and evolution to myelofibrosis and acute leukemia.

Interferon-α (IFN-α) was first shown to be effective in controlling thrombocytosis in patients with essential thrombocythemia (ET) and PV and later shown to be capable of limiting the excess red cell production in patients with PV.1 Lengfelder et al.2 summarized the treatment results with IFN-α therapy in 279 patients with PV. In addition to correction of thrombocytosis in approximately 90% of patients, a reduction of splenomegaly was observed in 77% of patients. Pruritus was controlled in 81% of patients, and the frequency of phlebotomy was reduced by 82%. Recombinant interferon-α (rIFN-α) inhibits erythroid progenitors and affects megakaryocyte function,3, 4 and thus may be a more rational treatment option for patients with PV. Since the initial studies of the use of rIFN-α in treating patients with PV, many reports of its beneficial effects have been published.1, 2 PV is now treated with rIFN-α with increasing frequency in order to avoid the complications associated with phlebotomy and/or chemotherapy, and to relieve pruritus and other constitutional symptoms. rIFN-α therapy is, however, associated with the need for frequent subcutaneous injections and a relatively high rate of side effects leading to the discontinuation of therapy in 21% of patients with PV and in 25% of patients with ET.2 To overcome these barriers, pegylated forms of rIFN-α (Peg-rIFN-α) have recently been explored as treatment options for patients with PV.5, 6 Peg-rIFN-α appears to be safe, non-leukemogenic and well tolerated, although adverse events including fever, thrombocytopenia and headache are not infrequent.

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Acknowledgements

This work was supported by grant 1P01CA108671 (to RH) from NCI and a grant (to MX) from the myeloproliferative disorder foundation.

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Authors and Affiliations

  1. Department of Medicine, Section of Hematology/Oncology, University of Illinois College of Medicine, Chicago, IL, USA

    T Ishii, M Xu, Y Zhao, W-Y Hu, S Ciurea, E Bruno & R Hoffman

  2. The Myeloproliferative disorder Research Consortium, University of Illinois College of Medicine, Chicago, IL, USA

    M Xu & R Hoffman

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Correspondence to M Xu.

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Ishii, T., Xu, M., Zhao, Y. et al. Recurrence of clonal hematopoiesis after discontinuing pegylated recombinant interferon-α 2a in a patient with polycythemia vera. Leukemia 21, 373–374 (2007). https://doi.org/10.1038/sj.leu.2404475

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