Interferon-alpha as maintenance therapy in patients with multiple myeloma.
BACKGROUND
The effect of interferon-alpha 2b (IFN-alpha-2b) on progression-free and overall survival as well as quality of life (QoL) was studied in mainly elderly patients with multiple myeloma (MM), who reached a plateau phase after melphalan/prednisone induction.


METHODS
In an open phase III trial, 262 patients, median age 69 years (range 34-91), received at least 10 monthly courses of melphalan/prednisone followed by response evaluation. Plateau phase was reached by 128 patients. Next, 90 patients were randomized between IFN-alpha-2b and no maintenance therapy. Reasons for non-randomization were: refusal (18), concomitant disease (nine), protocol violation (six), WHO performance status >2 (four) and allogeneic transplantation (one)


RESULTS
At a median follow-up from diagnosis of 97 months (0-140) for those patients alive, IFN-alpha-2b therapy was associated with improved progression-free survival (median 13.5 versus 8.4 months from randomization), although this did not translate in a better overall survival (41 versus 38.4 months). One-third of patients discontinued IFN-alpha due to toxicity. No differences were observed between patient groups in QoL.


CONCLUSIONS
IFN maintenance therapy in MM prolongs progression-free survival and, provided that the burden of toxicity is not too high, does not adversely affect QoL.
Schaar
C G
CG
Department of Internal Medicine, Gelre Hospitals, Apeldoorn, The Netherlands. c.schaar@gelre.nl
Kluin-Nelemans
H C
HC
Te Marvelde
C
C
le Cessie
S
S
Breed
W P
WP
Fibbe
W E
WE
van Deijk
W A
WA
Fickers
M M
MM
Roozendaal
K J
KJ
Wijermans
P W
PW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D011994:Recombinant Proteins; D016019:Survival Analysis
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins