We have heard a lot about a handful of patients on IFN in CCR who have managed to stay off Interferon without relapse. It is always good to go back into the Interferon studies to see what the relapse risk is in IFN patients on CCR. I give an article below and this shows that with IFN CCRs, there can be significant relapse risk so one has to factor that into account in any future Gleevec trials where IFN is added in CCR with the idea of going off meds. While IFN does act in a different way from Gleevec, by eliciting immune responses, it is to be seen with the help of trials how much IFN can do in the way of a cure in Gleevec CCR patients, especially as pitted against those who take CML vaccines after Gleevec CCR. Such a trial is soon going to be under way at the Sidney Kimmel Cancer Center.
While looking at IFN and vaccines as possible vehicles after Gleevec CCR to a short or long-term cure, one also must not discount ways other than immunotherapy, like killing of the quiescent cells by drug therapy as a possible way to a cure. Last ASH also reported such a drug from Bristol-Myers-Squibb. I was happy to see Dorothy's feedback, funding of CML research indeed does depend on institutions like NIH and steps taken to advocacy in this area is indeed very welcome for the future of a CML drug cure. Best Wishes, Anjana caregiver to Roy J Clin Oncol. 2002 Jan 1;20(1):214-20. Links Follow-up of complete cytogenetic remission in patients with chronic myeloid leukemia after cessation of interferon alfa. a.. Mahon FX, b.. Delbrel X, c.. Cony-Makhoul P, d.. Faberes C, e.. Boiron JM, f.. Barthe C, g.. Bilhou-Nabera C, h.. Pigneux A, i.. Marit G, j.. Reiffers J. Service des Maladies du Sang, Centre Hospitalier Universitaire de Bordeaux, Bordeaux 2, France. PURPOSE: A small proportion of patients with chronic myeloid leukemia (CML) achieve a complete cytogenetic response (CCR), defined as the disappearance of Philadelphia (Ph) chromosome-positive metaphases, after treatment with interferon alfa (IFN). In this population of patients, the question of whether treatment should then be withdrawn is not yet resolved. PATIENTS AND METHODS: In the present study, we followed 15 patients who stopped IFN after achieving CCR. In nine patients IFN was stopped in view of adverse reactions (n = 8) or patient's choice (n = 1). For the remaining six patients, the treatment was stopped because no BCR/ABL rearrangement could be detected by reverse transcriptase polymerase chain reaction (RT-PCR) in four successive analyses using peripheral-blood samples. RESULTS: Loss of CCR and survival were not statistically different (P =.48; P =.7) for the 15 patients who stopped IFN compared with 41 other CCR patients who continued IFN therapy in our institution. The median follow-up after discontinuation of IFN treatment was 36 months (range, 6 to 108 months). Seven patients (47%) (females, or CCR > 24 months and RT-PCR negative before IFN cessation; P <.0001) did not relapse. Eight other patients (53%) relapsed (lost CCR) within 3 to 33 months of treatment discontinuation. One of them relapsed in major cytogenetic remission (MCR) and was still in MCR 87 months after stopping therapy without any treatment. CONCLUSION: It is possible to stop IFN treatment at least in some patients with CML who achieve a prolonged period of CCR. This study also illustrates the hypothesis that persistence of low numbers of Ph-positive cells does not necessarily imply hematologic relapse. --~--~---------~--~----~------------~-------~--~----~ [CMLHope] A support group of http://cmlhope.com ------------------------------------------------- You received this message because you are subscribed to the Google Groups "CMLHope" group. To post to this group, send email to [email protected] To unsubscribe from this group, send email to [EMAIL PROTECTED] For more options, visit this group at http://groups.google.com/group/CMLHope -~----------~----~----~----~------~----~------~--~---
