INTERFERON-INDUCED VASOSPASM IN CHRONIC MYELOID-LEUKEMIA

The role of interferon (IFN) in the treatment of chronic myeloid leuka emia (CML) has been established. Many adverse effects have been report ed, but vasospasm has been extremely rare. We report 2 CML patients wh o developed such complications. A 56-year-old female had been on IFN f or 3 years with haematological and cytogenetic remission, when she dev eloped an anginal syndrome followed by acute ischaemia. Coronary cathe terization revealed normal arteries. After discontinuation of IFN her cardiac complaints disappeared and she needed no medication. A 61-year -old patient had been on IFN for 1 year when he presented with Raynaud 's phenomenon. No evidence of collagen vascular disease could be docum ented. IFN discontinuation and intravenous administration of iloprost (a prostacyclin analogue) resulted in the disappearance of the vascula r complications. IFN appears to have a beneficial effect on the course and prognosis of CML. However, we have to be aware of the potential c omplications and adverse effects which can be related to IFN. Neither our experience nor the literature provides convincing recommendations regarding the management of such patients. We suggest proceeding with IFN at lower doses, especially in those who have achieved a cytogeneti c response, as our first patient.