Innovative treatment strategies for non-Hodgkin's lymphoma and multiple myeloma.

Interferon-alfa (IFN-alpha) has been evaluated in non-Hodgkin's lymphoma and multiple myeloma. The preclinical evidence that IFN-alpha has antitumor activity against non-Hodgkin's lymphoma includes genetic deficits in IFN-alpha production in patients with non-Hodgkin's lymphoma, direct antiproliferative effects of IFN-alpha in stem cell assays, and beneficial effects of combined IFN-alpha and chemotherapy in experimental models. Interferon-alfa was active in phase I and II studies of patients receiving prior chemotherapy for non-Hodgkin's lymphoma, particularly those with low- to intermediate-grade lymphoma. The results of randomized studies suggest that adding IFN-alpha to chemotherapy as either induction or maintenance therapy may improve the outcome in patients with previously untreated non-Hodgkin's lymphoma. Interferon-alfa also appears to have activity as a single agent in patients with multiple myeloma, and eventually may have a role as maintenance therapy in patients with multiple myeloma. Collectively, these studies reveal a trend toward using IFN-alpha in patients with smaller hematologic tumor burden instead of reserving it as a last-resort measure.