Interferon treatment of chronic active hepatitis C during therapy of acutelymphoblastic leukemia

Due to concerns that antineoplastic therapy produces prolonged decrease in immune function, interferon treatment of chronic active hepatitis C (CAHC) has been used only at one year or longer after the end of cancer therapy. W e report the experience of an Ii-year-old who developed symptomatic CAHC at the start of maintenance therapy for testicular relapse of acute lymphobla stic leukemia (ALL). Significant dose reduction of maintenance therapy did not improve the tolerance of antileukemic treatment. In an effort to improv e his liver disease and to deliver effective antileukemic therapy, interfer on alpha and an alternative maintenance therapy regimen for ALL were initia ted. The patient tolerated the combined therapy well. Interferon therapy wa s continued for 27 months, which was three months from the end of antineopl astic therapy. At that time serum transaminase values were normal, and no H CV viral genome was detectable. Viral genome was detected 10 months later. The combined effects of interferon and antineoplastic therapy resulted in m yelosuppression requiring dose reduction of both treatments. The patient re mains asymptomatic and with no evidence of recurrent leukemia more than six years from diagnosis of relapse. The effect on the status of this patient' s CAHC was similar to that reported among leukemic patients who underwent a n interferon course more than one year from the end of antineoplastic thera py. Interferon treatment of CAHC can be given concomitantly with antineopla stic therapy. Am. J. Hematol. 61:130-134, 1999. (C) 1999 Wiley-Liss, Inc.