Result of interferon-alpha therapy in patients with chronic myelogenous leukemia 60 years of age and older.
OBJECTIVE
To determine the response rate to interferon-alpha (IFN-alpha) in patients with chronic myelogenous leukemia (CML) aged 60 years and older.


METHODS
Patients with CML aged 60 years and older included in all protocols with INF-alpha therapy for chronic phase CML at the M.D. Anderson Cancer Center were analyzed. They were treated with human leukocyte or recombinant human IFN-alpha 5x10(6) U/m2 daily alone or in combination with hydroxyurea or IFN gamma. The clinical characteristics of the patients were analyzed and their hematologic and cytogenetic responses to IFN-alpha and survival from the initiation of therapy were determined. Results were compared with those of younger patients treated in the same protocols. Treatment-related toxicity was also analyzed.


RESULTS
Thirty-five of 274 (13%) patients included in trials of IFN-alpha-based regimens for CML were 60 years and older. Older patients had a higher percentage of bone marrow blasts (P = 0.04) and basophils (P = 0.09) than younger patients. Sixty-nine percent achieved a complete hematologic remission with IFN-alpha therapy, and 51% had a cytogenetic response, which was major in 26% and complete (Philadelphia chromosome-positive cells = 0%) in 20%, Their median survival was 64 months, and the estimated 5-year survival rate was 62%. These results were not different from those in younger patients. Twenty-two patients (63%) had at least grade 2 toxicity requiring dose adjustment. The most frequent side effects were neurotoxicity in 31% and chronic fatigue in 29%.


CONCLUSIONS
Patients with CML 60 years of age and older respond well to IFN-alpha therapy, but experience more toxicity. This therapy should be considered for these patients if they are otherwise in good condition, with careful attention to IFN-alpha toxicity and its management.
Cortes
J
J
Department of Hematology, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA.
Kantarjian
H
H
O'Brien
S
S
Robertson
L E
LE
Pierce
S
S
Talpaz
M
M
D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001491:Basophils / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D012074:Remission Induction; D015996:Survival Rate; D013781:Texas
D000970:Antineoplastic Agents; D016898:Interferon-alpha; D007371:Interferon-gamma; D006918:Hydroxyurea