Interferon Alpha

The exact mechanism of action of interferon-alpha is unknown but a general antiproliferative action is supported by the reduction in circulating CFU-GM and BFU-E112 and occasional in vivo cytopenias observed following the introduction of this agent. Interferon also inhibits megakaryopoiesis and antagonizes platelet-derived growth factor, one of the fibrogenic paracrine factors secreted by platelets and megakaryocytes implicated in the pathogenesis of myelofibrosis.113 It has also been shown to prolong survival in patients with chronic myeloid leukemia by comparison with HU,114>115 with the degree of survival advantage correlating with its ability to restore normal (Philadelphia-negative) hematopoiesis. Interferon has been shown to control the hematocrit in 60 to 70 percent of patients within the first 6 to 12 months116 and has been shown to control the associated thrombocytosis, leukocytosis, and splenomegaly in the majority of patients where these occur.116-118 It appears to be particularly effective for the treatment of PV associated pruritus.117 Interferon is not thought to be leukemogenic and theoretically may decrease or delay the development of myelofibrosis, but this remains unproven in a randomized trial. Unfortunately interferon is associated with significant side effects, causing treatment withdrawal in up to one-third of all patients.116,119,120

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