INTERFERON-ALPHA IN CHILDHOOD HEMATOLOGICAL MALIGNANCIES

The application of cytostatics has brought about a breakthrough in the treatment of childhood haematological malignancies in the past 20 yea rs. Chemotherapy appears to be least successful in the rare, low and v ery high mitotic index diseases, which often have an enormous tumour-b urden. The suitability of chemotherapy in minimal residual leukaemia i s also of some doubt. In these situations a 'conservative' treatment m ay be more appropriate. Because interferon-alpha has a distinct mechan ism of action, and a broad-spectrum haematopoietic inhibitory activity , it is relatively nontoxic and noncancerogenic, and it may have a rol e in the treatment of malignant haematological disorders, either as a mono- or combination therapy. The exact indications and dosages for in terferon in childhood malignancies are far from clear. Up to now, it h as proved to be most efficacious in small tumour masses, providing a t heoretical basis for application in minimal residual disease. Controll ed clinical data, however, are not yet available. It remains to be det ermined whether or not interferon can be added to current chemotherapy protocols without a significant reduction of dose. Hopefully, a deepe r understanding of the activities of interferon will allow us to plan better trials with combination treatments.