LONG-TERM RESULTS OF INTERFERON TREATMENT IN HAIRY-CELL LEUKEMIA

Eighty nine of 104 patients with hairy cell leukemia (HCL), enrolled b etween 1985 and 1987 in a multicenter prospective study on human lymph oblastoid IFN alpha-n1, were evaluable for long-term follow-up. The in duction treatment, 3 MU/mq daily for a median of 5.7 months, produced a response of 93%, complete + partial response (CR + PR) = 80%, minor (MR) = 13%. Neither prior splenectomy nor pre-treatment variables were associated with the rate of response to IFN. However maintenance trea tment of 3 MU/mq weekly given randomly had a highly significant effect on failure free survival (FFS). Of the 43 patients who relapsed, 31/3 6 (86%) obtained a new response with IFN. No differences in FFS were r ecorded between first and second response. At the third induction 7/11 patients were treated again with IFN, 4/7 obtaining some response, bu t the FFS was significantly worse. The overall survival is still 85%. We conclude that (1) IFN should be used as chronic uninterrupted treat ment for HCL, (2) reduced dosage is sufficient to prolong the disease free status and (3) continuous lymphoblastoid IFN administration seems not to be associated with the development of resistance to retreatmen t.