Long Term Results of Interferon Treatment in Hairy Cell Leukemia Italian Cooperative Group of Hairy Cell Leukemia (ICGHCL)

Abstract

Eighty nine of 104 patients with hairy cell leukemia (HCL), enrolled between 1985 and 1987 in a multicenter prospective study on human lymphoblastoid IFN alpha-n1, were evaluable for long-term follow-up. The induction treatment, 3 MU/mq daily for a median of 5.7 months, produced a response of 93%, complete+partial response (CR+PR) = 80%, minor (MR) = 13%. Neither prior splenectomy nor pre-treatment variables were associated with the rate of response to IFN. However maintenance treatment of 3 MU/mq weekly given randomly had a slightly significant effect on failure free survival (FFS). Of the 43 patients who relapsed, 31/36 (86%) obtained a new response with IFN. No differences in FFS were recorded between first and second response. At the third induction 7/11 patients were treated again with IFN, 4/7 obtaining some response, but the FFS was significantly worse. The overall survival is still 85%. We conclude that (1) IFN should be used as chronic uninterrupted treatment for HCL, (2) reduced dosage is sufficient to prolong the disease free status and (3) continuous lymphoblastoid IFN administration seems not to be associated with the development of resistance to retreatment.

Hairy Cell Leukemia: An Elusive but Treatable Disease

“…This finding has been corroborated by other investigators. A large, multicenter, prospective trial of 104 HCL patients lead by the Italian Cooperative Group of Hairy Cell Leukemia (ICGHCL) showed an overall response rate of 93%, with a CR rate of 13% [50]. Several mechanisms have been postulated for the rapid activity of interferon in HCL.…”

Role of interferon‐alpha administration after 2‐deoxycoformycin in the treatment of hairy cell leukemia patients

“…Quesada et al (13) first described the efficacy of IFN in HCL and subsequently other studies clearly demonstrated that IFN is an effective treatment for HCL, both as initial therapy and in previously treated patients (2, 14–16). Moreover, IFN‐ α therapy resulted in recovery of immunological function in patients with HCL characterized by an increase in the number of monocytes and a restoration of natural killer and T cell function (17, 18).…”