Whither Interferon for Myeloma and Other Hematologic Malignancies?

Multiple myeloma is one of the common hematologic malignancies now affecting approximately 12 500 persons in the United States each year. The number of patients with this condition continues to increase as a result of more frequent screening with electrophoresis and more diagnoses among a progressively aging population. Despite intensive study of many treatments, including those supported by stem cell transplantation, overall survival has not improved, and the disease remains incurable [1]. Accordingly, the best available strategy has been to achieve a high frequency of remission that can be sustained for several years, and then to repeatedly control relapsing disease with a series of effective and well-tolerated treatments.

Since interferon-α became available 15 years ago, its role in the treatment of multiple myeloma has been controversial. Early studies [2, 3] showed that disease could be controlled in approximately 20% of newly diagnosed patients, but only rarely in patients with disease resistant to standard therapies. Neither of two studies [4, 5] that assessed a combination of interferon and standard alkylating agent-glucocorticoid therapy detected a consistent improvement in long-term outcome. The median remission time of responding patients was prolonged by 4 to 12 months with interferon compared with no treatment in four controlled studies [6-9], although no benefit was seen in two other studies …