A prospective comparison between treatment with phlebotomy alone and with interferon-alpha in patients with polycythemia vera

Interferon alpha (alpha-IFN) is increasingly used for the treatment of patients affected by polycythemia vera (PV). As prior studies are difficult to interpret in view of the lack of appropriate controls, we undertook a randomized comparison of lymphoblastoid alpha-IFN (alpha n-1 IFN) treatment agai...

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Bibliographic Details
Published in:Annals of hematology 1994-05, Vol.68 (5), p.247-250
Main Authors: SACCHI, S, LEONI, P, UCCI, G, FALZETTI, F, GRIGNANI, F, MARTELLI, M. F, LIBERATI, M, RICCARDI, A, TABILIO, A, TARTONI, P, MESSORA, C, VECCHI, A, BENSI, L, RUPOLI, S
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Bloodletting
Chromosome Aberrations
Combined Modality Therapy
Female
Humans
Interferon-alpha - therapeutic use
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Polycythemia Vera - genetics
Polycythemia Vera - pathology
Polycythemia Vera - therapy
Prospective Studies
Splenomegaly
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Summary:Interferon alpha (alpha-IFN) is increasingly used for the treatment of patients affected by polycythemia vera (PV). As prior studies are difficult to interpret in view of the lack of appropriate controls, we undertook a randomized comparison of lymphoblastoid alpha-IFN (alpha n-1 IFN) treatment against venesection treatment alone. In a crossover trial, we treated 22 PV patients alternatively for 5 months each with 3 MU/day sc of alpha n-1 IFN and phlebotomy alone. During IFN treatment, red blood cell count and hematocrit level were well controlled in both trial groups, reducing or eliminating the need for phlebotomy in all patients; furthermore, platelet number and white blood cell count declined during alpha-IFN therapy. In addition, the number of symptomatic patients was greatly reduced, and in six patients a reduction in splenic size was observed. Finally, the only patient with chromosomal abnormalities showed a complete cytogenetic conversion after 5 months of alpha-IFN therapy. Thus, for the first time, our results provide the unequivocal demonstration that alpha-IFN is superior to phlebotomy in controlling the pathologic expansion of erythroid elements and all the clinical aspects of this disease.
ISSN:0939-5555
1432-0584
DOI:10.1007/BF01737425