Interferon Therapy in Myelofibrosis: Systematic Review and Meta-analysis |
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| Affiliation: | 1. Department of Internal Medicine, Section of Hematology, Yale School of Medicine, New Haven, CT;2. Division of Hematology and Oncology, University of Alabama School of Medicine, Birmingham, AL;3. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, CT;4. Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT;5. Laboratory of Metabolic Regulation and Genetics, The Rockefeller University, New York, NY;6. Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY;1. Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA;2. Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA;1. Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY;2. Department of Human Pathology, University of Messina, Messina, Italy;3. Department of Biological and Environmental Sciences, University of Messina, Messina, Italy;4. Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria;5. Department of Hematology and CBMT, Ospedale di Bolzano, Bolzano, Italy;1. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;2. Hematology Unit, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy;3. Guy''s and St Thomas'' NHS Foundation Trust, London, United Kingdom;4. The University of Texas MD Anderson Cancer Center, Houston, TX, USA;5. Memorial Sloan-Kettering Cancer Center, New York, NY, USA;6. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy;7. University Hospitals Leuven and Laboratory of Molecular Immunology (Rega Institute), KU Leuven, Leuven, Belgium;8. University of Insubria, Varese, Italy;9. Division of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;10. University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA;11. Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy;12. Hôpital Saint-Louis, Université de Paris, Paris, France;13. Leukemia Department, University of Texas MD Anderson Cancer Center, Houston, TX, USA;14. Sonic Healthcare USA, Austin, TX, USA;15. Mayo Clinic, Rochester, MN, USA;16. Constellation Pharmaceuticals a MorphoSys Company, Boston, MA, USA;17. Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada;1. Hematology Department, Hospital Clínic, Institut d''Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;2. Hematology Division, University Hospital Paolo Giaccone, Palermo, Italy;3. Department of Haematology, Guy''s and St Thomas'' NHS Foundation Trust, London, UK;4. Université de Paris, AP-HP, HÔpital Saint-Louis, Centre d''Investigations Cliniques, INSERM, CIC1427, Paris, France;5. Oncology, Hemostaseology and Palliative Care, Johannes Wesling Medical Center Minden UKRUB, University of Bochum, Germany;6. Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, TX, USA;7. Service d''Hématologie Clinique, Institut de Cancero-Hematologie, CHRU de Brest, Brest, France;8. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy;9. Hematology Department, Hospital Clínico Valencia, Valencia, Spain;10. Department of Medical Sciences, Uppsala University, Uppsala, Sweden;11. Wellcome Sanger Institute, Cambridge, UK;12. Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany;13. Department of Molecular Medicine, University of Pavia, Pavia, Italy;14. FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy |
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| Abstract: | BackgroundMyelofibrosis (MF) is a Philadelphia chromosome–negative myeloproliferative neoplasm characterized by progressive bone marrow failure, increased risk of progression to acute myeloid leukemia, and constitutional symptoms. For over 3 decades, various formulations of interferon (IFN) have been used for the treatment of MF, with variable results, and the role of IFN in the treatment of MF is evolving.Patients and MethodsFor this systematic review and meta-analysis, Medline and Embase via Ovid, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched from inception through March 2019 for studies of pegylated IFN (peg-IFN) and non–peg-IFN in MF patients. The primary outcome of overall response rate was defined as a composite of complete response, partial response, complete hematologic response, and partial hematologic response. Random-effects models were used to pool overall response rate, and metaregression analyses were performed to compare peg-IFN and non-–peg-IFN formulations.ResultsAmong the 10 studies with 141 MF patients included, the overall response rate was 49.9% (95% confidence interval [CI], 30.4-69.3), and there was no statistically significant difference (P = .99) between peg-IFN (50.0%; 95% CI, 26.2-73.9; I2 = 76.9%) and non–peg-IFN (49.6%; 95% CI, 20.5-79.0; I2 = 56.7%). Treatment discontinuation resulting from adverse events was common with non–peg-IFN at 35.8% (95% CI, 3.5-68.1) per year, and less in the one study on peg-IFN (0.5% per year).ConclusionIFN can lead to hematologic improvements in a subset of MF patients, but study quality is limited and heterogenous. Biomarkers predicting response to IFN and formulations with improved tolerability are needed. |
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| Keywords: | Adverse events Interferon Meta-analysis Myelofibrosis Systematic review |
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