Document Detail


High incidence of autoimmune alterations in chronic myeloid leukemia patients treated with interferon-alpha.
MedLine Citation:
PMID:  12605388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Interferon-alpha is the frontline therapy of the majority of chronic myeloid leukemia (CML) patients who are not eligible for bone marrow transplantation. Many patients are treated for long periods, and there is concern about the long-term immune effects of its use. Autoimmune disorders in patients treated with IFN-alpha may be related to the direct immunomodulating properties of IFN or may be linked to a possible toxic effect in target organs, triggering autoimmunity. On the other hand, the immune effects of IFN may play a role in its therapeutic actions. The aims of our study were to assess the incidence of autoimmune phenomena in these patients, and to measure the possible association between the generation of autoimmune phenomena and the antileukemic effect of IFN alpha. Therefore, 46 patients with Ph1(+) CML in the first chronic phase were studied for the appearance of immune complications, their connection to IFN dose, time of appearance, and the possible association with the response to treatment. Autoimmune abnormalities have been found in 28% of our patients. Moreover, a significant association was found between autoimmune alterations and female sex (P = 0.02, OR 4.5, 95% CI 1.13-17.9) and a longer treatment time (1.6 vs. 4.1 years) (P = 0.02; OR 1.01, 95% CI 1-1.02). The Kaplan-Meier estimated probability of obtaining a cytogenetic response was significantly higher in patients who developed autoimmune alterations (P = 0.049), and this difference was also evident in Cox's analysis when controlling with other potentially confounding variables (P = 0.078). We conclude that CML patients treated with IFN alpha have a high incidence of autoimmune phenomenon.
Authors:
J L Steegmann; M J Requena; P Martín-Regueira; R De La Cámara; F Casado; F Rodriguez Salvanés; J M Fernández Rañada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of hematology     Volume:  72     ISSN:  0361-8609     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-26     Completed Date:  2003-03-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  170-6     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Department of Hematology, Hospital de la Princesa, Madrid, Spain. fundsteeg@nexo.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Autoantibodies / blood
Autoimmune Diseases / epidemiology,  etiology*
Coombs' Test
Female
Humans
Interferon-alpha / adverse effects*,  therapeutic use
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
Male
Middle Aged
Sex Characteristics
Thyroiditis, Autoimmune / epidemiology,  etiology
Time Factors
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Interferon-alpha; 0/interferon-alpha 2

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