Interferon alpha-2b in the long-term treatment of essential thrombocythemia

1991 ◽  
Vol 63 (4) ◽  
pp. 206-209 ◽  
Author(s):  
S. Sacchi ◽  
A. Tabilio ◽  
P. Leoni ◽  
A. Riccardi ◽  
A. Vecchi ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Essential Thrombocythemia ◽  
Term Treatment ◽  
Interferon Alpha 2B ◽  
Long Term Treatment

Long-term treatment with recombinant interferon alpha-2b prolongs survival of asymptomatic HIV-infected individuals

Biotherapy ◽  
1997 ◽  
Vol 10 (2) ◽  
pp. 107-113 ◽  
Author(s):  
J. Rivero ◽  
M. Fraga ◽  
I. Cancio ◽  
J. Cuervo ◽  
P. López-Saura
Keyword(s):  
Interferon Alpha ◽  
Term Treatment ◽  
Recombinant Interferon ◽  
Interferon Alpha 2B ◽  
Long Term Treatment ◽  
Recombinant Interferon Alpha ◽  
Asymptomatic Hiv

Essential Thrombocythemia: A Prospective Analysis of Efficacy and Safety of Anagrelide for Long Term Treatment in Patients Below and Above the Age of 60 Years.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3561-3561 ◽  
Author(s):  
Heinz Gisslinger
Keyword(s):  
Disease Progression ◽  
Essential Thrombocythemia ◽  
Term Treatment ◽  
Younger Patients ◽  
Platelet Counts ◽  
Patient Cohort ◽  
Long Term Treatment ◽  
History Of

Abstract Thromboembolic complications and less frequently bleeding characterize morbidity and mortality in patients with essential thrombocythemia (ET). The average estimated risk for thrombotic episodes in ET is 6.6% per patient year and platelet counts above 1000G/L, older age (>60 years) and a history of thrombosis were identified as major risk factors for serious complications. Since a direct correlation of platelet numbers with the number of thrombotic events is suggested by numerous prospective trials, it is generally accepted that these patients should receive platelet lowering treatment. Although hydroxyurea is considered as the treatment of choice in ET, there is still major concern about leukemogenicity of this compound. Anagrelide, on the other hand seems to be better tolerated in younger patients, but this has not been proved by prospective studies. It is therefore the aim of the present study to compare tolerability and efficacy of anagrelide (Thromboreductin, a novel non-immediate release formulation of anagrelide) over a prolonged time between ET patients below the age of 60 years with those above the age of 60 years. Among a total of 722 patients with ET on anagrelide who were prospectively documented within a standardized patient registry, 386 patients were previously untreated at the time of initiation of anagrelide therapy and this therapy was prospectively documented up to 5 years. The median age of this previously untrated patient cohort was 58 years (6 to 91 years), 179 (46,4%) patients were older than 60 years and 274 (71%) patients were female. Sixtythree patients (16,3%) had a history of thrombosis. The main inclusion criteria were those defined for qualifying a patient to be at high risk. During the first two years of follow up, the group of younger patients (< 60 years) did receive higher daily doses of anagrelide as compared to the older patient cohort (2,0mg vs.1,5mg). Anagrelide reduced platelet counts from a median baseline value of 920G/L to 581G/L and 382 G/L on month 3 and month 60 respectively. The overall response rate (platelet counts< 600G/L) was 64%. The rate of complete response (platelet counts <450G/L) went up from 58% after one year to 71% after 5 years of treatment. Group comparisons showed that a significant response to anagrelide was achieveable in patients below and above the age of 60 years with no significant difference between the two groups. With regard to safety, there is no evidence that anagrelide gives concern to an increased rate of bleeding (2%) or disease progression. Over the 5 year follow up period an adverse event was recorded in 24% of patients. The rate of treatment discontinuation as a result of adverse events was low (5%), treatment was discontinued when no further response was achieved or a negative risk benefit judgement of the treating physician was made. Only 4 patients of the whole cohort discontinued anagrelide due to disease progression. A small number of patients (12/722), 1,7%) died during the 5 years observation period, all cases were described as not drug related. In summary the data confirm that anagrelide yields comparable response rates in the two age groups during long term treatment.

scholarly journals Thyroid autoimmunity and hypothyroidism during long-term treatment with recombinant interferon-alpha

2008 ◽  
Vol 90 (3) ◽  
pp. 363-367 ◽  
Author(s):  
H. GISSLINGER ◽  
B. GILLY ◽  
W. WOLOSZCZUK ◽  
W.R. MAYR ◽  
L. HAVELEC ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Thyroid Autoimmunity ◽  
Term Treatment ◽  
Recombinant Interferon ◽  
Long Term Treatment ◽  
Recombinant Interferon Alpha

Long-Term Interferon-α Treatment in Essential Thrombocythemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4064-4064 ◽  
Author(s):  
Frank Stegelmann ◽  
Stefanie Schauer ◽  
Rebecca Kirschbaum ◽  
Hartmut Döhner ◽  
Richard F. Schlenk ◽  
...  
Keyword(s):  
High Risk ◽  
Essential Thrombocythemia ◽  
Research Funding ◽  
Jak2 V617f ◽  
Term Treatment ◽  
High Risk Patients ◽  
Long Term Treatment ◽  
Risk Patients

Abstract Background: Essential thrombocythemia (ET) is a chronic myeloid stem cell disorder characterized by an uncontrolled production of platelets. Common complications are recurring thrombotic events and/or haemorrhage. Although ET is in general associated with good prognosis, prognostically adverse events such as fibrotic or leukemic transformation occur at an increasing risk in patients with long disease duration. Since interferon-α (IFN-α) harbors the potential of inducing molecular remission in approximately 20% of ET patients as demonstrated by JAK2 V617F, the drug may prolong the natural course of the disease. Therefore, in particular younger ET patients are likely to benefit from long-term IFN-α treatment.Since data on long-term effects of IFN-α treatment are scarce, we here report on safety, efficacy, and molecular markers from ET high-risk patients being treated with IFN-α at our institution for up to 21 years. Results: Within 12 months (Jan 2014 - Dec 2014), 73 ET patients at the median age of 61 years (range 31-97) presented for regular follow-up at our out-patient clinic. All patients have given informed consent for data evaluation according to the Declaration of Helsinki. Eighty-one percent (59/73) were high-risk characterized by the presence of ≥1 of the following risk factors: i) age >60 years, ii) previous thrombosis, or iii) platelet count >1.500/nL. All high-risk patients received cytoreductive therapy: Hydroxyurea (HU) was the most frequent drug administered at last follow-up (27/59, 46%), followed by IFN-α (18/59, 30%), anagrelide (11/59, 19%), or HU plus anagrelide (3/59, 5%). At the time of data evaluation, no ET patient was treated with an approved or experimental drug within a clinical study. Of the 59 high-risk patients, a total number of 27 patients (46%) were currently (n=18) or previously (n=9) treated with IFN-α (conventional IFN-α, n=3; pegylated IFN-α, n=24). Median age of the total IFN-α cohort was 54 years (range 40-85). Main reasons for IFN-α initiation in these patients were previous thrombosis (n=16, 59%) and high platelet count (n=7, 26%), followed by age >60 years (n=4, 15%). Interestingly, one third of patients (9/27) received IFN-α as a long-term therapy for 10-21 years. IFN-α was discontinued in the 9 previously treated patients after a median treatment time of 71 months (range 1-206). Main reasons for discontinuation were depression/fatigue (n=3), arthralgia (n=2), diarrhea/nausea (n=2), lack of response (n=1), or myocardial infarction (n=1). Of note, the myocardial infarction represented a thromboembolic event and occurred in complete hematologic remission under long-term treatment with IFN-α (206 months). No further vascular events were recorded under IFN-α therapy. Given a total observation time of 211 patient years, the vascular complication rate in our IFN-α cohort is 0.13 per patient and year. Furthermore, no disease progression to secondary myelofibrosis or acute myeloid leukemia occurred during the whole observation period. Since JAK2 V617F had been identified in the year 2005, peripheral blood from all ET patients presenting at our out-patient clinic was preserved. In approximately one half of the 27 patients, IFN-α treatment was initiated before (n=14, 52%) or after (n=13, 48%) the year 2005. Mutation testing in the earliest samples available from each patient revealed mutation frequencies of JAK2 V617F, MPL W515L, and CALR of 52% (14/27), 0% (0/27), and 30% (8/27) in the total IFN-α population. Interestingly, patients under long-term treatment with IFN-α (10-21 years) were either triple-negative (n=3) or CALR mutated (n=6) at the sensitivity limit of DNA-based fragment analysis (~1%). Serial quantification of the JAK2 V617F allele burden before and under IFN-α could be performed in 10 patients and showed a decrease from 10.5% (5-27%) to 2.9% (0.1-22%) at the last follow-up (p = .004). Conclusions: We conclude from our data that long-term treatment with IFN-α for 10 years or more is feasible in approximately one third of high-risk ET patients. In our patients receiving IFN-α, vascular complications were restricted to a single event in an observation time of 211 patient years, whereas no disease progressions to secondary myelofibrosis or acute myeloid leukemia occurred. Controlled clinical trials are warranted to prove the long-term benefit of IFN-α treatment in high-risk ET. Disclosures Off Label Use: Interferon-alpha is used and recommended for decades in therapy of essential thrombocythemia although randomized clinical trials leading to approval of the drug are lacking.. Schlenk:Pfizer: Honoraria, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees; Arog: Honoraria, Research Funding; Boehringer-Ingelheim: Honoraria; Daiichi Sankyo: Membership on an entity's Board of Directors or advisory committees; Teva: Honoraria, Research Funding; Novartis: Honoraria, Research Funding.

Tumorous manifestation of hairy cell leukemia after long-term treatment with interferon alpha

1995 ◽  
Vol 70 (2) ◽  
pp. 103-105
Author(s):  
S. Serke ◽  
D. Kaiser ◽  
A. Schmitt-Gr�ff ◽  
H. Stein ◽  
D. Huhn ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Hairy Cell Leukemia ◽  
Term Treatment ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Long Term Treatment

Tumorous manifestation of hairy cell leukemia after long-term treatment with interferon alpha

1995 ◽  
Vol 70 (2) ◽  
pp. 103-105 ◽  
Author(s):  
D. Huhn ◽  
J. Oertel ◽  
S. Serke ◽  
D. Kaiser ◽  
A. Schmitt-Gräff ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Hairy Cell Leukemia ◽  
Term Treatment ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Long Term Treatment
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