A phase I trial of α‐interferon in combination with pentostatin in hematologic malignancies

Abstract

Pentostatin, a novel inhibitor of adenosine deaminase, has shown activity in various lymphoid malignancies of both the T and B cell lineage. This agent has unique side effects and in general myelosuppression has been mild. Interferon has both antiviral and antineoplastic properties. This agent has shown activity in hairy cell leukemia, chronic granulocytic leukemia, low grade lymphoma, and myeloma. Side effects from interferon are in general dissimilar to those that have been seen with pentostatin and in particular myelosuppression has not been a major toxicity with low doses of interferon. This current trial explored the combination of pentostatin and interferon in hematologic malignancies. Fifteen patients were enrolled in this phase I trial at a fixed dose of pentostatin of 4 mg/m2 biweekly and interferon at doses of 0.5, 1, 2, or 4 million units/m2 of interferon. At the first three dose levels of interferon nausea and vomiting were the predominant toxicity and appeared to worsen with time on study. Fatigue also was seen at the lowest level of interferon and was severe enough to cause two individuals to discontinue the study medications. At higher dose levels of interferon, myelosuppression, nausea and vomiting, and fatigue were the predominant toxicities. One patient with hairy cell leukemia had a complete response and a second patient with T cell cutaneous lymphoma had a partial response which lasted for 6 to 7 weeks. The maximum tolerated dose of interferon with pentostatin in this patient population was four million units/m2.

Interferon in the treatment of cutaneous T-cell lymphoma

“…Bernard et al. (60) also utilized deoxycoformycin 4 mg/m 2 IV, but every 2 weeks for 3 months and then monthly for 9 months, along with IFN‐α2b 0.5–4 Mµ/m 2 three times a week beginning at week 3. One‐third of these CTCL patients developed progressive disease on therapy.…”

Interferon treatment of cutaneous T‐cell lymphoma

“…IFN therapy has also been combined with extracorporeal photochemotherapy (40), and with an inhibitor of adenosine deaminase termed pentostatin (41), and both combinations have induced responses in patients with CTCL. However the number of patients is too small for any conclusions.…”

Development and evaluation of screening dysphagia tools for observational studies and routine care in cancer patients

“…Regardless of cause, when symptoms are not managed effectively, they can impact patients' functional status, affect, and HRQoL . Further, unrelieved symptoms can cause patients to interrupt or abandon treatment or decrease adherence to treatment regimens …”

“…[4][5][6][7][8][9] Further, unrelieved symptoms can cause patients to interrupt or abandon treatment 10,11 or decrease adherence to treatment regimens. [12][13][14][15][16][17][18] As essential a role that symptom PROs play in multidisciplinary cancer care, barriers exist that may result in suboptimal symptom assessment. Outpatient clinics must balance the need for comprehensive symptom assessments, while minimizing patient burden.…”