title: Interferon-alpha 2b in the treatment of follicular lymphoma: preliminary results of a trial in progress.
abstract: Since 1985 the combination of chlorambucil (10 mg daily, initially for six weeks, then alternating fortnights for 12 weeks) and interferon-alpha 2b (Schering-Plough; 2 x 10(6) U/m2 three times weekly by subcutaneous injection for 18 weeks) has been compared in a randomised trial with chlorambucil alone in previously untreated patients with stage III or IV follicular lymphoma. Responding patients have subsequently been randomised to receive maintenance interferon-alpha 2b or no further treatment. Of the 124 treated patients, 108 are evaluable for response with a median follow-up of 30 months. The major toxicity was myelosuppression which was more frequent with chlorambucil and IFN alpha 2b in combination than with chlorambucil alone (P less than 0.01). There was no treatment-related mortality. Actuarial survival at three years is 75% for all patients, regardless of therapy. There was no significant difference in response rate according to initial therapy. For the 60 patients achieving a good response to initial therapy who have entered the second part of the trial, there has been a significant prolongation of remission duration in favour of maintenance IFN-alpha 2b (median not yet reached versus two years for the 'no treatment' arm, P less than 0.015). Fewest relapses have been seen in patients who received IFN-alpha 2b throughout. Accrual to this trial continues; this preliminary analysis indicates that maintenance IFN-alpha 2b may extend remission duration in follicular lymphoma.
authors.affiliation: ICRF Dept of Medical Oncology, St. Bartholomew's Hospital, London, United Kingdom.
authors.forename: C G
authors.initials: CG
authors.lastname: Price
authors.forename: A Z
authors.initials: AZ
authors.lastname: Rohatiner
authors.forename: W
authors.initials: W
authors.lastname: Steward
authors.forename: D
authors.initials: D
authors.lastname: Deakin
authors.forename: N
authors.initials: N
authors.lastname: Bailey
authors.forename: A
authors.initials: A
authors.lastname: Norton
authors.forename: G
authors.initials: G
authors.lastname: Blackledge
authors.forename: D
authors.initials: D
authors.lastname: Crowther
authors.forename: T A
authors.initials: TA
authors.lastname: Lister
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002699:Chlorambucil / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008224:Lymphoma, Follicular / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012008:Recurrence; D012074:Remission Induction; D015996:Survival Rate
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D002699:Chlorambucil