Prior interferon therapy for CML has no effect on stem cell transplant outcome


NEW YORK (Reuters Health) – Chronic myelogenous leukemia (CML) patients who undergo a trial of interferon (IFN) therapy before attempting unrelated donor hematopoietic stem cell transplantation do not have inferior transplant outcomes, according to findings published in the December 1st issue of Blood.

Dr. Mary M. Horowitz, of the Medical College of Wisconsin, in Milwaukee, and a multicenter team examined the impact of pretransplant IFN therapy on outcomes in 740 CML patients who received bone marrow transplants from unrelated donors. Of the patients, 489 (66%) had received pretransplant IFN and 251 (34%) had not.

Disease characteristics were similar in the two groups at baseline but not at the time of transplant, the authors explain. At transplant, patients in the pretransplant IFN group had lower weight and hematologic parameters and a longer interval from diagnosis to transplant compared with patients who received no IFN treatment.

Nevertheless, the two groups fared similarly in terms of overall, leukemia-free, and relapse-free survival, as well as engraftment, relapse and acute or chronic graft-versus-host disease at 5 years posttransplant.

Also, while data on duration of IFN were missing for one-third of patients, the investigators found no evidence of a link between prolonged or recent exposure to IFN and poor patient outcomes, as has been reported.

"Patients who prefer a trial of IFN-based therapy and assessment of cytogenetic response before…proceeding to unrelated donor transplantation may be reassured that we did not find an independent adverse effect of this exposure if they later undergo stem cell transplantation," Dr. Horowitz and colleagues conclude.

They add that they also found no evidence of a need to discontinue interferon therapy 3 months before stem cell transplantation, as is currently practiced.

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