title: Meta-analysis to evaluate the role of interferon in follicular lymphoma.
abstract: OBJECTIVE
  To determine whether interferon (IFN) -alpha2, when given with or following chemotherapy, influences response rate, remission duration, and survival in newly diagnosed patients with follicular lymphoma.
  
  
  METHODS
  Ten phase III studies evaluating the role of IFN-alpha2 in 1,922 newly diagnosed patients with follicular lymphoma were analyzed. Updated individual patient data were used to perform meta-analyses for response, survival, and remission duration.
  
  
  RESULTS
  The addition of IFN-alpha2 to initial chemotherapy did not significantly influence response rate. An overall meta-analysis for survival showed a significant difference in favor of IFN-alpha2, but also showed significant heterogeneity between studies. Further analyses were carried out in order to explain this heterogeneity, and to define the circumstances in which IFN-alpha2 prolonged survival. The survival advantage was seen when IFN-alpha2 was given: (1) in conjunction with relatively intensive initial chemotherapy (2P = .00005), (2) at a dose >/= 5 million units (2P = .000002), (3) at a cumulative dose >/= 36 million units per month (2P = .000008), and (4) with chemotherapy rather than as maintenance therapy (P = .004). With regard to remission duration, there was also a significant difference in favor of IFN-alpha2, irrespective of the intensity of chemotherapy used, IFN dose, or whether IFN was given as a maintenance strategy or with chemotherapy.
  
  
  CONCLUSIONS
  When given in the context of relatively intensive initial chemotherapy, and at a dose >/= 5 million units (>/= 36 x 10(6) units per month), IFN-alpha2 prolongs survival and remission duration in patients with follicular lymphoma.
authors.affiliation: Department of Medical Oncology, St Bartholomew's Hospital, 45 Little Britain, London, EC1A 7BE, United Kingdom. ama.rohatiner@cancer.org.uk
authors.forename: A Z S
authors.initials: AZ
authors.lastname: Rohatiner
authors.forename: W M
authors.initials: WM
authors.lastname: Gregory
authors.forename: B
authors.initials: B
authors.lastname: Peterson
authors.forename: E
authors.initials: E
authors.lastname: Borden
authors.forename: P
authors.initials: P
authors.lastname: Solal-Celigny
authors.forename: A
authors.initials: A
authors.lastname: Hagenbeek
authors.forename: R I
authors.initials: RI
authors.lastname: Fisher
authors.forename: M
authors.initials: M
authors.lastname: Unterhalt
authors.forename: R
authors.initials: R
authors.lastname: Arranz
authors.forename: T
authors.initials: T
authors.lastname: Chisesi
authors.forename: A
authors.initials: A
authors.lastname: Aviles
authors.forename: T A
authors.initials: TA
authors.lastname: Lister
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins