Journal of Clinical Oncology, Vol 10, 631-634, Copyright © 1992 by American Society of Clinical Oncology
Elevated circulating levels of tumor necrosis factor predict unresponsiveness to treatment with interferon alfa-2b in chronic myelogenous leukemia
F Herrmann, SG Helfrich, A Lindemann, E Schleiermacher, C Huber and R Mertelsmann
Department of Internal Medicine 1, University of Freiburg, Germany.
PURPOSE: The study was undertaken to analyze circulating tumor necrosis
factor (TNF) levels in patients with chronic-phase chronic myelogenous
leukemia (CML) undergoing interferon (IFN) alfa-2b therapy, and to
correlate pretreatment serum levels of TNF with response to IFN alfa-2b
therapy. PATIENTS AND METHODS: Fourteen patients with CML in chronic phase
were treated with recombinant human IFN alfa-2b for 7 to 39 months.
RESULTS: In eight patients IFN alfa-2b treatment failed due to lack of
hematologic response. A complete or partial hematologic remission was
achieved in the remaining six patients, of whom two patients experienced a
complete cytogenetic response. Retrospective analysis of serum samples
obtained from all patients before the onset of IFN alfa-2b administration
revealed that levels (mean +/- SEM) of circulating TNF were higher (P less
than .001) in the group of patients who did not respond to IFN alfa-2b
treatment (157 +/- 15 U/mL) than in the responders (10.3 +/- 4 U/mL) or
healthy control subjects (9.1 +/- 3 U/mL). However, there was no
correlation between TNF serum levels and other patient characteristics at
study enrollment including age, sex, duration of disease, performance
status, splenomegaly, WBC count, platelet count, hemoglobin value, prior
therapy, and prognostic category. CONCLUSION: These findings indicate that
circulating levels of TNF are increased in a subset of patients with
chronic-phase CML and that this elevation is associated with poor response
to IFN alfa-2b therapy.
