title: Multicenter prospective study of interferon alpha versus allogeneic stem cell transplantation for patients with new diagnoses of chronic myelogenous leukemia.
abstract: We compared interferon alpha (IFN-alpha) therapy with stem cell transplantation (SCT) for patients with chronic-phase chronic myelogenous leukemia in a multicenter prospective study to investigate the optimal indication and timing of SCT, especially from HLA-matched unrelated donors. Of 257 eligible patients, 145 patients who were younger than 50 years were assigned to the IFN-alpha cohort (n = 87) or the SCT cohort (n = 58), according to family donor availability. In the IFN-alpha cohort, 52 patients received IFN-alpha and chemotherapy (the IFN1 group), and 35 patients received an SCT from an unrelated donor (the U-SCT group). In the SCT cohort, 47 patients received an SCT from a related donor (the R-SCT group). In the IFN1 group, 88% of the patients achieved a complete hematologic response, and 33% achieved a complete cytogenetic response. At a median follow-up period of 53 months, the predicted 6-year survival rate was 72% in the IFN1 group, 81% in the R-SCT group, and 81% in the U-SCT group. When overall survival was evaluated for the IFN-alpha and R-SCT cohorts by intention to treat according to family donor availability, the 6-year survival rates were 76% and 84%, respectively. When the outcomes of the U-SCT and IFN1 groups were compared, the survival rate of U-SCT group patients was significantly better than for IFN1 group patients without a major cytogenetic response and seemed better for IFN1 group patients younger than 35 years. Therefore, U-SCT may be recommendable to patients who fail to achieve a major cytogenetic response in IFN-alpha therapy and to younger patients.
authors.affiliation: Department of Medicine III, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan. kohnishi@hama-med.ac.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Akio
authors.initials: A
authors.lastname: Ino
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Noriko
authors.initials: N
authors.lastname: Usui
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shimazaki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ohtake
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Taguchi
authors.forename: Fumiharu
authors.initials: F
authors.lastname: Yagasaki
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Hotta
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ohno
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D006801:Humans; D016898:Interferon-alpha / Q000592:standards* / Q000627:therapeutic use; D015466:Leukemia, Myeloid, Chronic-Phase / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D016019:Survival Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha