Lymphocyte recovery and clinical response in multiple myeloma patients receiving interferon alpha 2 beta after intensive therapy.
The recovery of immunoregulatory cells in the peripheral blood of patients with multiple myeloma receiving maintenance therapy with interferon alpha 2 beta (IFN-alpha 2 beta) after intensive therapy with high-dose melphalan and autologous bone marrow or peripheral blood stem cell rescue was studied. IFN-alpha 2 beta significantly inhibited the recovery of CD3+, CD4+, CD8+, CD56+/CD3- and CD16+/CD3- lymphocytes compared with numbers found in patients who had no further post-transplant treatment, but had no effect on the recovery of CD19+ cells. Among patients who did not receive IFN-alpha 2 beta, the number of CD8+, CD56+/CD3- and CD16+CD3- lymphocytes recovered to values similar to normal volunteers with increasing time after intensive therapy, however the number of CD4+ cells remained significantly below levels found in normal volunteers. Although CD16+/CD3- and CD56+/CD3- cell numbers were reduced in patients receiving IFN-alpha 2 beta, natural killer (NK) activity was not affected. The levels of soluble interleukin 2 receptor (sIL-2R) were similar in all patients and IL-2 was not detected in any patient. At the time of writing, of the total of 69 patients, seven have relapsed, of whom three were receiving IFN-alpha 2 beta, however there was no correlation between the absolute numbers of any lymphocyte subset with imminent relapse. The data suggest that the recovery of a specific lymphocyte subset(s) in peripheral blood is unlikely to be associated with the maintenance of response after intensive therapy.
Millar
B C
BC
Section of Academic Haematology, McElwain Laboratories, Institute of Cancer Research, Sutton, Surrey, UK.
Bell
J B
JB
Powles
R L
RL
D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000097:blood; D007694:Killer Cells, Natural / Q000187:drug effects; D018655:Lymphocyte Count / Q000187:drug effects; D016131:Lymphocyte Subsets / Q000187:drug effects* / Q000502:physiology; D008558:Melphalan / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000032:analysis; D011994:Recombinant Proteins; D012008:Recurrence; D012074:Remission Induction; D018709:Statistics, Nonparametric
D018906:Antineoplastic Agents, Alkylating; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007376:Interleukin-2; D015375:Receptors, Interleukin-2; D011994:Recombinant Proteins; D008558:Melphalan