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Interferon- 2b: A New Treatment for Polycythemia Vera
- From the New York Hospital-Cornell Medical Center, New York, New York. Requests for Reprints: Richard T. Silver, MD, Section of Clinical Oncology Chemotherapy Research, New York Hospital-Cornell Medical Center, 525 East 68 Street, Box 581, New York, NY 10021. Acknowledgments: The author thanks Helen Zurawinsky, BS, for administrative assistance, Audrey Gutfriend, BS, RN, for patient care responsibilities, and Arthur Sawitsky, MD, and Ted P. Szatrowski, MD, PhD, for review of the manuscript. Grant Support: In part by grants from the United Leukemia Fund and Cancer Research and Treatment Fund, Inc. No funds for this study were requested or provided by Schering Corporation, the manufacturer of recombinant interferon- 2b (Intron-A). However, three patients have been supplied with Intron-A on a compassionate basis at my request.
Polycythemia vera is characterized by an increased red cell mass and thrombohemorrhagic complications. In general, treatment has consisted of phlebotomy to reduce the red cell mass. However, because treatment with phlebotomy only is associated with early, frequently fatal thrombosis or hemorrhage [1], myelosuppressive therapy is also used. Unfortunately, the agents used, chlorambucil and radioactive phosphorus, are leukemogenic [1].
Although hydroxyurea is used as an alternative drug, a potential for leukemia still exists [2], especially in patients who develop postpolycythemic myeloid metaplasia [3]. Despite conventional treatment, many patients experience night sweats and pruritus [4] and develop iron deficiency. The inexorable course of polycythemia vera includes progressive splenomegaly and myelofibrosis. For all these reasons, other treatments are required [1].
Recombinant interferon- has myelosuppressive activity [5, 6]. Platelet-derived growth factor, a product of megakaryocytes, initiates proliferation of fibroblasts that may be involved in the myelofibrosis of advanced polycythemia vera. Interferon- antagonizes the action of platelet-derived growth factor by inhibiting the activation of Go cells for G1 …
