Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, Jiangsu, China.
Institute of Blood and Marrow Transplantation, Suzhou, China.
Ann Hematol. 2018 Nov;97(11):2195-2204. doi: 10.1007/s00277-018-3429-z. Epub 2018 Jul 11.
Interferon-α (IFN-α) inhibits tumor growth and mimics graft-versus-leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the current case-control study, we compared treatment responses in acute leukemia patients with relapse tendency post-allo-HSCT receiving preemptive IFN-α after withdrawal of immunosuppressants (n = 31) vs. receiving no IFN-α (n = 67). In the IFN-α group, 25 patients responded to the treatment without progressing to hematological relapse. In the non-IFN-α group, only 22 patients responded to the treatment. The response rate differed significantly (80.6 vs. 32.8%, P < 0.001). The 2-year cumulative incidence of relapse was 31.6 and 61.2% in the IFN-α and the non-IFN groups, respectively (P = 0.006). The 2-year leukemia-free survival and overall survival rate was 57.4 vs. 28.4% (P < 0.001) and 67.6 vs. 32.9% (P = 0.001), respectively. Among the 31 patients in the IFN-α group, 18 patients (58.1%) developed graft-versus-host disease (GVHD): 6 acute and 12 limited chronic GVHD. Patients who developed GVHD had higher treatment response rate than patients without GVHD (88.9 vs. 53.8%, P = 0.022). In conclusion, preemptive IFN-α therapy is a safe and effective treatment to prevent disease progression in high-risk patients with relapse tendency post-allo-HSCT.
干扰素-α (IFN-α) 可抑制肿瘤生长，并在异基因造血干细胞移植 (allo-HSCT) 后模拟移植物抗白血病效应。在本病例对照研究中，我们比较了接受免疫抑制剂撤药后预防性 IFN-α治疗（n=31）与未接受 IFN-α治疗（n=67）的复发倾向急性白血病 allo-HSCT 后患者的治疗反应。IFN-α 组中，25 例患者在未进展为血液学复发的情况下对治疗有反应。在非 IFN-α 组中，仅有 22 例患者对治疗有反应。两组的反应率差异显著（80.6% vs. 32.8%，P<0.001）。IFN-α 组和非 IFN-α 组 2 年累积复发率分别为 31.6%和 61.2%（P=0.006）。IFN-α 组和非 IFN-α 组 2 年无白血病生存率和总生存率分别为 57.4%和 28.4%（P<0.001）和 67.6%和 32.9%（P=0.001）。在 IFN-α 组的 31 例患者中，18 例（58.1%）发生移植物抗宿主病（GVHD）：6 例急性和 12 例慢性局限型 GVHD。发生 GVHD 的患者治疗反应率高于未发生 GVHD 的患者（88.9% vs. 53.8%，P=0.022）。总之，预防性 IFN-α 治疗是一种安全有效的治疗方法，可预防 allo-HSCT 后复发倾向高危患者疾病进展。
