Claudia Fiorani, Stefania Tonelli, Barbara Casolari and Stefano Sacchi* Pages 987 - 1013 ( 27 )
The interferons are cytokines with a wide array of biological properties. In hematological malignancies the most used IFN class is -ex; it has been used for thirty years but the mode of action is still not absolutely clear. Nevertheless, the benefits of IFN-cx for the treatment of CMD have been described in particular for CML and less for PV, ET and MMM.
IFN-cx is presently considered the golden standard of therapy for CML patients not eligible for SCT; the antileukemic effect has been well documented by hematological and cytogenetic response. The survival . advantage for IFN treated patients is remarkable in comparison with patients treated with conventional chemotherapy. Recently, the combination IFN-cx plus Ara-C has demonstrated to increase the rate of major cytogenetic response and to prolong survival.
To date, there is not a generally accepted treatment for ET, PV and MMM, which can reduce the risk of thromboembolism and/or hemorragic events. In several subsets of ET and PV patients, IFN-cx can be considered as first line therapy.
IFN-cx is usually associated with the development of early and later side effects, that reduce the enthusiasm for its use. In the future PEG-IFN-cx would improve the quality of life of IFN-treated CMD patients.