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

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

Research output: Contribution to journalArticle

Abstract

Treatment of P190(BCR-ABL+) acute lymphoblastic leukemia (ALL) patients remains problematic: one possibility is to use biologic response modifiers such as A-interferon (A-IFN), which is known to be active in chronic myeloid leukemia (CML). We used (A-IFN to treat 10 adult P190(BCR-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 A-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 A-IFN (6 weeks on, 6 off). Eight patients (6/6 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 A-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). A-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 P190(BCR-ABL+) ALL patients (and by extension for Ph+ ALL patients) lacking an HLA-matched donor.

Original languageEnglish
Pages (from-to)22-27
Number of pages6
JournalLeukemia
Volume14
Issue number1
Publication statusPublished - 2000

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Keywords

  • BGR-ABL
  • Bone marrow transplantation
  • Interferon
  • Leukemia
  • Lymphoblastic
  • P-190

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

Visani, G., Martinelli, G., Piccaluga, P., Tosi, P., Amabile, M., Pastano, R., Cavo, M., Isidori, A., & Tura, S. (2000). Alpha-interferon improves survival and remission duration in P-190(BCR-ABL) positive adult acute lymphoblastic leukemia. Leukemia, 14(1), 22-27.