Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2021 Sep;35(9):2592-2601.
doi: 10.1038/s41375-021-01183-8. Epub 2021 Mar 2.

Interferon-alpha for treating polycythemia vera yields improved myelofibrosis-free and overall survival

Ghaith Abu-Zeinah  1 , Spencer Krichevsky  1 , Tatiana Cruz  1 , Gabriela Hoberman  1 , Diana Jaber  1 , Niamh Savage  1 , Claudia Sosner  1 , Ellen K Ritchie  1 , Joseph M Scandura  1 , Richard T Silver  2
Affiliations
Clinical Trial

Interferon-alpha for treating polycythemia vera yields improved myelofibrosis-free and overall survival

Ghaith Abu-Zeinah et al. Leukemia. 2021 Sep.

Abstract

Interferon-alpha (rIFNα) is the only disease-modifying treatment for polycythemia vera (PV), but whether or not it prolongs survival is unknown. This large single center retrospective study of 470 PV patients compares the myelofibrosis-free survival (MFS) and overall survival (OS) with rIFNα to two other primary treatments, hydroxyurea (HU) and phlebotomy-only (PHL-O). The median age at diagnosis was 54 years (range 20-94) and the median follow-up was 10 years (range 0-45). Two hundred and twenty-nine patients were women (49%) and 208 were high-risk (44%). The primary treatment was rIFNα in 93 (20%), HU in 189 (40%), PHL-O in 133 (28%) and other cytoreductive drugs in 55 (12%). The treatment groups differed by ELN risk score (p < 0.001). In low-risk patients, 20-year MFS for rIFNα, HU, and PHL-O was 84%, 65% and 55% respectively (p < 0.001) and 20-year OS was 100%, 85% and 80% respectively (p = 0.44). In high-risk patients, 20-year MFS for rIFNα, HU, and PHL-O was 89%, 41% and 36% respectively (p = 0.19) and 20-year OS was 66%, 40%, 14% respectively (p = 0.016). In multivariable analysis, longer time on rIFNα was associated with a lower risk of myelofibrosis (HR: 0.91, p < 0.001) and lower mortality (HR: 0.94, p = 0.012). In conclusion, this study supports treatment of PV with rIFNα to prevent myelofibrosis and potentially prolong survival.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest:

GAZ – Consultancy, PharmaEssentia. SK, TC, GH, DJ, NS, CS, EKR, and JMS – No conflicts of interest to disclose. RTS – Speaker bureau and consultancy, PharmaEssentia.

Figures

Figure 1:
Figure 1:. Myelofibrosis-free survival (MFS) and overall survival (OS) of PV patients.
A MFS of all patients, B OS of all patients, C MFS of all patients by ELN risk, D OS of all patients by ELN risk, E MFS of low-risk patients by treatment group, F OS of low-risk patients by treatment group, G MFS of high-risk patients by treatment group, H OS of high-risk patients by treatment group.
Figure 2:
Figure 2:. Fibrosis grade MF2-3 over time on treatment.
significant differences by chi-squared test are noted at p<0.01(**) and p<0.001 (***)).
Figure 3:
Figure 3:. Cytoreductive treatment timeline of PV study population ordered by first treatment and its duration.
The results are censored at the earlier of last follow up or transformation to PPVMF.
See this image and copyright information in PMC

References

    1. Passamonti F, Giorgino T, Mora B, Guglielmelli P, Rumi E, Maffioli M et al.A clinical-molecular prognostic model to predict survival in patients with post polycythemia vera and post essential thrombocythemia myelofibrosis. Leukemia 2017; 31: 2726–2731. - PubMed
    1. Spivak JL. Myeloproliferative Neoplasms. N Engl J Med 2017; 376: 2168–2181. - PubMed
    1. Masarova L, Yin CC, Cortes JE, Konopleva M, Borthakur G, Newberry KJ et al.Histomorphological responses after therapy with pegylated interferon α−2a in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Exp Hematol Oncol 2017; 6: 30. - PMC - PubMed
    1. Silver RT. Long-term effects of the treatment of polycythemia vera with recombinant interferon-alpha. Cancer 2006; 107: 451–8. - PubMed
    1. Kiladjian J-J, Cassinat B, Chevret S, Turlure P, Cambier N, Roussel M et al.Pegylated interferon-alfa-2a induces complete hematologic and molecular responses with low toxicity in polycythemia vera. Blood 2008; 112: 3065–3072. - PubMed

Publication types

LinkOut - more resources