An extremely delayed cytogenetic response to interferon-alpha in a patient with chronic myeloid leukaemia.
In chronic myeloid leukaemia (CML), treatment with interferon alpha IFN-alpha results in loss of the Ph' chromosome in a significant proportion of patients. Most cytogenetic responses occur early at a median of 9 months after initiation of treatment and failure to detect a cytogenetic response within a predetermined period may be a reason for IFN-alpha withdrawal. We report a patient in whom IFN-alpha dosage was initially severely limited by bone marrow suppression but in whom continuing treatment led to a first cytogenetic response only after 53 months. Increasing Ph' negativity over a further 2 years was associated with improving haematological tolerance which permitted IFN-alpha dose escalation and complete cytogenetic remission was achieved at 7 years after diagnosis. This remission has been sustained and has thus followed the most delayed cytogenetic response to IFN-alpha so far reported.
Whiteway
A J
AJ
Northwick Park Hospital, Harrow, Middlesex, UK.
Reid
C D
CD
Cross
N C
NC
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000235:genetics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D012074:Remission Induction; D013997:Time Factors
D000970:Antineoplastic Agents; D016898:Interferon-alpha