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Long-Term Interferon Associated with Worsening Side Effects in MPN

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The use interferon as initial therapy in MPN is associated with worsening side effects the longer it is used for treatment. These results were recently presented at the 2016 annual meeting of the American Society of Hematology.
Myeloproliferative neoplasms (MPN) are a related group of blood cancers. In these disorders, the bone marrow cells that produce blood cells develop and function abnormally. The three main types of MPN are polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). In addition to developing on its own, myelofibrosis may also develop as a result of ET or PMF.
Myeloproliferative neoplasms are most common in older adults. Out of every 100,000 people in the United States, an estimated 44 to 57 people have PV, and a similar number have ET. Myelofibrosis is less common, affecting 4 to 6 people per 100,000.
Quality of life issues associated with treatment are an important consideration for patients with MPNs, as some drugs can cause severe side effects without a clear benefit in outcomes, compared to other treatment choices.

Researchers affiliated with the Myeloproliferative Disorders Research Consortium recently conducted a global phase III trial, referred to as the MPD-RC 112 trial to compare initial treatment for patients with high-risk PV and ET. The interim trial results were presented at the 2016 ASH meeting.

Patients in the trial were treated with either pegylated interferon alpha-2a (PEG), or with hudroxyurea (HU) and were directly compared.

• Overall, responses to treatment were similar between the two groups of patients
• Patients experienced different degrees of disease symptoms while on therapy, as well as different side effects associated with PEG and HU.
• Side effects from PEG tended to worsen the longer patients received treatment.

The researchers concluded that longer-term results from this study will help to clarify the different side effects experienced from treatment with either PEG or HU. The researchers also noted that since side effects with PEG tended to get worse with lengthening of treatment, it will be beneficial to determine if long-term disease control with PEG is worth the reduced quality of life associated with long-term use of PEG.

References:
1. Mascarenhas J, Prchal J, Rambaldi A, et al. Interim Analysis of the Myeloproliferative Disorders Research Consortium (MPD-RC) 112 Global Phase III Trial of Front Line Pegylated Interferon Alpha-2a Vs. Hydroxyurea in High Risk Polycythemia Vera and Essential Thrombocythemia. Proceedings from the 2016 annual meeting of the American Society of Hematology. Abstract #479.
2. Mesa R, Hoffman R, Kosiorek H, et al. Impact on MPN Symptoms and Quality of Life of Front Line Pegylated Interferon Alpha-2a Vs. Hydroxyurea in High Risk Polycythemia Vera and Essential Thrombocythemia: Interim Analysis Results of Myeloproliferative Disorders Research Consortium (MPD-RC) 112 Global Phase III Trial. Proceedings from the 2016 annual meeting of the American Society of Hematology. Abstract #4271.