title: [Comparison of therapeutic effects of low-dose versus high-dose interferon alpha-2b treatment on chronic myelocytic leukemia: a prospective randomized study].
abstract: OBJECTIVE
  To compare the therapeutic effects of low-dose and high-dose interferon alpha-2b (IFN) treatment on chronic myelocytic leukemia (CML).
  
  
  METHODS
  A real-time quantitative reverse transcriptase PCR (RQ-PCR) method was established to detect the fusion gene bcr-abl expression, thereby studying the reduction of leukemic cells. Thirty newly diagnosed CML patients, 21 males and 9 females, aged 14 - 69, were treated with hydroxyurea to keep the white blood cell count less than 20 x 10(9)/L, and then randomized into 2 groups: high-dose IFN group receiving IFN alpha-2b 5MIU 6 times per week for 3 - 6 months and low-dose IFN group receiving IFN alpha-2b 3MIU every other day for 3 - 6 months. Bone marrow was collected every month to Real-time PCR was used to detect the expression of bcr-abl mRNA. Mononuclear cells were isolated and RNA was extracted to detect the expression of fusion gene bcr-abl and a control gene GAPDH. The results were reported as the number of bcr-abl copies/GAPDH copy.
  
  
  RESULTS
  The established real-time quantitative PCR method could detect the bcr-abl molecules as low as 50 copies. The intra-assay coefficient of variation (CV) was less than 5% and the inter-assay CV was 5.13%. The median bcr-abl fusion gene expression level of 30 CML patients before IFN therapy was 0.098 (range: 0.010 - 5.799). The bcr-abl expression level decreased by 19.37% and 24.86% in the low-dose and high-dose IFN groups respectively after 3 months' therapy. No significant difference was observed between the two groups (P = 0.398). Relatively more side effects were observed in the high-dose IFN group than in low-dose group.
  
  
  CONCLUSIONS
  RQ-PCR is a reliable method to monitor CML therapy by analyzing fusion gene bcr-abl expression. There is a difference in bcr-abl fusion gene expression levels among the newly diagnosed patients, and low-dose IFN is as effective as high-dose IFN in reducing bcr-abl expression but with less side effects.
authors: Department of Hematology, Peking University First Hospital, Beijing 100034, China.
authors: Jin-wei
authors: JW
authors: Du
authors: Ping
authors: P
authors: Zhu
authors: Ding
authors: D
authors: Tian
authors: Zuo-ren
authors: ZR
authors: Dong
authors: Shu-lian
authors: SL
authors: Yang
authors: Song-bo
authors: SB
authors: Li
authors: Ya-hui
authors: YH
authors: Tang
authors: Hui
authors: H
authors: Liu
authors: Xi-nan
authors: XN
authors: Cen
authors: Ying
authors: Y
authors: Zhang
authors: Qiang
authors: Q
authors: Zhu
authors: Yu-lin
authors: YL
authors: Zhu
authors: Ying
authors: Y
authors: Yang
authors: Dong-xia
authors: DX
authors: Wang
authors: Zhao
authors: Z
authors: Wang
authors: Hua
authors: H
authors: Cui
authors: Yi-gai
authors: YG
authors: Ma
authors: Wen-ming
authors: WM
authors: Chen
authors: Fu-qiang
authors: FQ
authors: Liu
authors: Jian
authors: J
authors: Ma
authors: Jing-wen
authors: JW
authors: Wang
authors: Ti
authors: T
authors: Shen
authors: Wan-ming
authors: WM
authors: Da
mesh_terms: D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D011994:Recombinant Proteins; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D014158:Transcription, Genetic
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012333:RNA, Messenger; D011994:Recombinant Proteins; D016044:Fusion Proteins, bcr-abl