Dr. Bishop provides a round-up of presentations given at the Hematologic Malignancies symposium, held in conjunction with the Mid-Atlantic Oncology Program's 13th Annual Scientific Conference.
ATLANTA, Ga--More than 75 investigators from around the world presented updates of ongoing clinical trials and initial data from new trials involving hematologic malignancies. This report includes results of studies from Italy, France, and the United States on treatments for acute and chronic leukemias.
An Italian study suggests that alpha-interferon should be the first-line treatment for chronic myelogenous leukemia (CML) patients who are not candidates for allogeneic transplantation, Michele Baccarani, MD, University Hospital of Udine, Italy, said in his update of the Italian Cooperative Groups study of alpha-interferon versus hydroxyurea (Hydrea) in the treatment of newly diagnosed CML.
Dr. Baccarani emphasized that allogeneic stem cell transplantation may be curative in up to 50% to 70% of CMLpatients; however, allogeneic transplantation is limited to approximately 15% of patients, due to age restrictions and donor availability.
In this study, patients who were ineligible to undergo allogeneic stem cell transplantation were randomized to receive alpha-interferon or hydroxyurea. The endpoints of this trial were hematologic response; karyotypic response, ie, reduction in the number of cells expressing the Philadelphia chromosome; and overall survival.
If patients randomized to receive alpha-interferon did not achieve a hematologic response by 6 months, the drug was discontinued. Likewise, among the remaining patients in this arm, the drug was dropped if a karyotypic response was not achieved by 1 year.
Median survival for patients randomized to receive alpha-interferon was 6 years, compared with 4 years for patients randomized to receive hydroxyurea (P = .001). Patients who received alpha-interferon appeared to have a slower progression from chronic phase to accelerated phase and blast crisis. The survival advantage was only observed in patients who achieved a karyotypic response, which occurred in approximately 30% of the study patients.