Alpha Interferon in Lymphoproliferative Disorders after Autologous Bone Marrow Transplantation (ABMT).

Background: It has been known since the early 1930s that cells infected with viruses are capable of protecting other cells from viral infection. Isaacs and Lindenmann discovered the protein that partially explained this phenomenon and named it interferon (IFN). Within a few years, the antiproliferative and immunomodulatory cellular effects of this molecule had been identified. Minimal residual disease (MRD) is the main cause of relapse and death, after autologous bone marrow transplantation (ABMT).

Aim: to study the efficacy and safety of IFN-α as maintenance therapy after ABMT in patients with chronic lymphoproliferative disorders.

Methods: 80 patients treated by ABMT were evaluated; 32 non Hodgkin lymphoma, 30 Hodgkin’s disease & 12 multiple myeloma. Gender: 39 men and 41 women. Age from 18 to 60 years old (media 45). On the day 90 after ABMT, they started receiving IFN-α (Roferon-A®) 3 MU, subcutaneously, three times a week, during 12 to 18 months (media 14 months). The historical control population (CP) was selected from the international literature, on patients of the same age group and sex distribution, not receiving IFN-α after ABMT (

Results: no patient’s dead ocurred as a consequence of IFN-α treatment. 80% of side effects in patients receiving interferon were acute. The majority of them are constitutional. They include fatigue, fever, chills, myalgias, headache and anorexia (flu-like syndrome). The appearance of tachyphylaxis depends on the type of IFN used, the route and schedule of administration. These symptoms are usually controlled with paracetamol 500 mg before and after IFN administration. Administration of IFN during the evening or at bed time has been succesful in minimizing the effects of peack toxicity. The hematologic effects of IFN therapy include leukopenia, anemia and thrombocytopenia. The fatigue associated with IFN therapy is often chronic and may require a dose reduction (5% of our patients). The most frequent neurologic side effects are depression, confusion and mental slowing. Mild proteinuria can be seen (low frequency; 1%). Whole alopecia was not present in this cohort. Overall survival (OS) and disease - free interval survival (DFI-S) was evaluated in each group of patients. Hodgkin’s disease OS 89% (75% CP), DFI-S 84% (64% CP); non Hodgkin’s lymphomas OS 87% (55% CP), DFI-S 56% (39% CP); multiple myeloma OS 92% (52% CP), DFI-S 66% (33% CP). Log rank test highly significant in favor of the population treated with IFN-a (p<0,001).

Conclusions: IFN-α has clearly demonstrated its usefulness inducing prolongation of disease free and overall survival in LPDs after ABMT, This may be accomplished by administration of adjuvant IFN to patients at high risk of recurrent disease after ABMT.

drnovoa51@yahoo,es or drnovoa@netgate.com.uy.