Development of systemic lupus erythematosus after interferon therapy for chronic myelogenous leukemia

Article Abstract:

Interferon is a natural substance that interferes with the replication of some viruses in cells, and appears to play an important role in many aspects of the immune response. There are actually several interferons; interferon-alpha is becoming more widely used in the treatment of cancer. However, as this substance has become more widely used, the list of possible side effects has grown. One possible effect, although rare, appears to be the development of systemic lupus erythematosus (SLE). The authors describe the case of a 19-year-old man with chronic myelogenous leukemia. He had originally been treated with a variety of chemotherapeutic drugs prior to treatment with interferon-alpha. The patient achieved complete remission and took interferon-alpha for a total of 45 months before developing 6 of the 11 diagnostic criteria for SLE. These include joint pain, intermittent fever and chills, and the development of a erythematous maculopapular (large, red, pimple-like) rash on the face and upper arms. The diagnosis of SLE was then supported by laboratory finding of autoantibodies against DNA, as well as other components of the cell nucleus that are typical of SLE. The interferon-alpha treatment was discontinued. The patient was placed on prednisone, a steroid anti-inflammatory drug, after signs of kidney problems continued to increase. Protein in the patient's urine decreased, as did the typical autoantibodies indicating systemic lupus. The patient continued without symptoms of SLE for five months, at which point his leukemia relapsed. The case illustrates that the development of systemic lupus erythematosus may be a complication of treatment with interferon-alpha. It is not known if the interferon-alpha exacerbates a pre-existing condition, causes SLE only in patients with a predisposition, or causes the condition in a small fraction of all patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Systemic lupus erythematosus, Leukemia

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Interferon-alpha produces sustained cytogenetic responses in chronic myelogenous leukemia

Article Abstract:

Chronic myelogenous leukemia is often associated with the presence of the Philadelphia chromosome, or chromosome 22 that has lost a portion of its genetic material. The typical course of the disease for the patients who have the Philadelphia chromosome involves a benign phase followed by transformation to a severe and often fatal phase known as a blastic crisis. Some intensive chemotherapy regimens can achieve the recovery of Philadelphia chromosome-negative cells, but this is generally transient. Alpha-interferons are naturally-occurring proteins that have a number of clinical effects, including antitumor activity. A study was performed in which 96 patients who were Philadelphia chromosome-positive with chronic myelogenous leukemia were treated with interferon. Of these, 70 patients (73 percent) achieved a complete hematological remission, or a return of normal blood counts with no signs or symptoms of disease. Nineteen of the patients in remission had a cytogenetic response, or the complete disappearance of the Philadelphia chromosome. For the 70 patients who responded successfully to interferon, remission lasted an average of 41 months. Relapse of chronic myelogenous leukemia was attributed to the emergence of resistance in the leukemic cells to interferon; relapse occurred less frequently in those patients who had achieved a partial or total cytogenetic response. Current data show a median survival for patients treated with interferon of 62 months, compared with 39 months for patients receiving other chemotherapy regimens. Ten-year survival rates are not yet available, but should help to determine the true contribution of alpha-interferon to survival in chronic myelogenous leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Myeloid leukemia, Philadelphia-positive, Philadelphia-positive myeloid leukemia

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Prolonged survival in chronic myelogenous leukemia after cytogenetic response to interferon-alpha therapy

Article Abstract:

Patients with chronic myelogenous leukemia who go into remission following treatment with interferon-alpha may have improved survival rates. Chronic myelogenous leukemia is a type of blood cancer that most often occurs in adults. Researchers administered interferon-alpha-based treatment regimens to 274 patients with early phase chronic myelogenous leukemia. After an average treatment period of one year, 72 patients achieved complete remission and 32 achieved partial remission. The four-year survival rate was 93% in patients in complete remission, 88% in those in partial remission, and 50% in patients not in remission. Patients in remission had one-fifth the risk of death compared to those who were not. Patients in remission had improved survival rates, regardless of their cancer stage.

Patient outcomes, Mortality, Prognosis, Cancer patients, Chronic myeloid leukemia

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