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Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa- 2a’nın Etkinliği ve Güvenliği

Year 2025, Volume: 78 Issue: 1, 60 - 68, 31.03.2025
https://doi.org/10.4274/atfm.galenos.2025.36744

Abstract

Amaç: Bazı klinik çalışmalarda, pegile interferon alfa-2a (PEG-IFN-α-2a) ile tedavi edilen esansiyel trombositemi (ET) ve polisitemia vera (PV)
hastalarında umut verici sonuçlar bildirmiştir. Biz de bu çalışmada, kendi kliniğimizde takip ve tedavi ettiğimiz miyeloproliferatif neoplazm (MPN)
tanılı hastalarımızda PEG-IFN-α-2a etkinlik ve güvenilirliğini değerlendirdik.
Gereç ve Yöntem: Bu retrospektif analizde, 2014 ve 2021 yılları arasında tanı almış ve PEG-IFN-α-2a ile tedavi edilmiş, 39 MPN tanılı hastanın (25
ET, 13 PV, 1 primer miyelofibrozis) sonuçlarını sunduk.
Bulgular: Hastaların ortanca yaşı 49 (aralık, 23-71) olup, çoğunluğu (%92) daha önce en az bir sıra farklı sitoredüktif tedaviyi almıştı. PEG-IFN-α-
2a’nın ortanca başlangıç dozu 126 mcg/hafta (aralık, 22,5-180 mcg/hafta) olup, hastalar tedaviyi kendine-enjeksiyon ile uygulanmıştır. Hastalar
ortanca 24 ay (aralık, 1-77) tedavi almıştır. Polisitemi vera ve ET tanılı hastalarda tüm yanıt oranları sırasıyla %84,6 ve %92 olarak bulunmuştur. Tüm
hastalar arasında tedavi süresinde gözlemlenen en yaygın yan etkiler yorgunluk (%71), miyalji (%54) ve artralji (%53) olmuştur.
Sonuç: Sonuçlarımız, PEG-IFN-α-2a’nın, özellikle uzun süreli sitotoksik tedaviden kaçınmak isteyen daha genç hastalar için uygulanabilir bir tedavi
seçeneği olabileceğini göstermektedir.

Project Number

-

References

  • Tefferi A, Vainchenker W. Myeloproliferative neoplasms: molecular pathophysiology, essential clinical understanding, and treatment strategies. J Clin Oncol. 2011;29:573-582.
  • 2. Spivak JL. Myeloproliferative neoplasms. N Engl J Med. 2017;376:2168-2181.
  • 3. Platanias LC. Mechanisms of type-I- and type-II-interferon mediated signalling. Nature Reviews Immunol. 2005;5:375-386.
  • 4. Kiladjian J-J, Giraudier S, Cassinat B. Interferon-alpha for the therapy of myeloproliferative neoplasms: targeting the malignant clone. Leukemia. 2016;30:776-781.
  • 5. Gowina K, Jaina T, Kosiorek H, et al. Pegylated interferon alpha-2a is clinically effective and tolerable in myeloproliferative neoplasm patients treated off clinical trial. Leukemia Research. 2017;54:73-77.
  • 6. Quintas-Cardama A, Kantarjian H, Manshouri T, et al. Pegylated interferon alfa-2a yields high rates of hematologic and molecular response in patients with advanced essential thrombocythemia and polycythemia vera. J Clin Oncol. 2009;27:5418-5424.
  • 7. Gowin K, Thapaliya P, Samuelson J, et al. Experience with pegylated interferon alpha-2a in advanced myeloproliferative neoplasms in an international cohort of 118 patients, Haematologica. 2012;10:1570-1573.
  • 8. Utke Rank C, Bjerrum OW, Larsen TS, et al. Minimal residual disease after long-term interferon-alpha2 treatment: a report on hematological, molecular and histomorphological response patterns in 10 patients with essential thrombocythemia and polycythemia vera. Leuk Lymphoma. 2016;57:348-354.
  • 9. Barosi G, Besses C, Birgegard G, et al. A unified definition of clinical resistance/ intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia. 2007;21:277-280.
  • 10. Barosi G, Birgegard G, Finazzi G, et al. Response criteria for essential thrombocythemia and polycythemia vera: result of a European Leukemia Net consensus conference. Blood. 2009;113:4829-4233.
  • 11. Barosi G, Bordessoule D, Briere J, et al. Response criteria for myelofibrosis with myeloid metaplasia: results of an initiative of the European Myelofibrosis Network (EUMNET). Blood. 2005;106:2849-2853.
  • 12. Tefferi A, Cervantes F, Mesa R, et al. Revised response criteria for myelofibrosis: international working group-Myeloproliferative neoplasms Koyun et al. Myeloproliferative Neoplasm Pegylated Interferon Alpha-2a J Ankara Univ Fac Med 2025;78(1):60-68 68 research and treatment (IWG-MRT) and european LeukemiaNet (ELN) consensus report. Blood. 2013;122:1395-1398.
  • 13. Barosi G, Mesa R, Finazzi G, et al. Revised response criteria for polycythemia vera and essential thrombocythemia: an ELN and IWGMRT consensus project. Blood. 2013;121:4778-4781.
  • 14. Mascarenhas J, Kosiorek HE, Prchal JT, et al. Results of the myeloproliferative neoplasms-research consortium (MPN-RC) 112 randomized trial of pegylated interferon alfa-2a (PEG) versus hydroxyurea (HU) therapy for the treatment of high risk polycythemia vera (PV) and high risk essential thrombocythemia (ET) [Abstract]. Blood. 2018;132(Suppl 1):577.
  • 15. Masarova L, Patel KP, Newberry KJ, et al. Pegylated interferon alfa-2a in patients with essential thrombocythaemia or polycythaemia vera: a post hoc, median 83 month follow-up of an open-label, phase 2 trial. Lancet Haematol. 2017;4:e165-175.
  • 16. Yacoub A, Mascarenhas J, Kosiorek H, et al. Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood. 2019;134:1498-1509.
  • 17. Kiladjian JJ, Masse A, Cassinat B, et al. Clonal analysis of erythroid progenitors suggests that pegylated interferon alpha-2a treatment targets JAK2V617F clones without affecting TET2 mutant cells. Leukemia. 2010; 24:1519-1523.
  • 18. Verger E, Cassinat B. Clinical and molecular response to interferon-alpha mtherapy in essential thrombocythemia patients with CALR mutations. 2015;126:2585-2591.
  • 19. Kiladjian JJ, Cassinat B, Chevret S, et al. Pegylated interferon-alfa-2a induces complete hematologic and molecular responses with low toxicity in polycythemia vera. Blood. 2008;112:3065-3072.
  • 20. Crisà E, Cerrano M, Beggiato E et al. Can pegylated interferon improve the outcome of polycythemia vera patients? J Hematology Oncol. 2017;10:15.
  • 21. Marchioli R, Finazzi G, Specchia G, et al. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368:22-33.
  • 22. Gisslinger H, Klade C, Georgiev P, et al. Ropeginterferon alfa-2b versus standard therapy for polycythaemia vera (PROUD-PV and CONTINUATIONPV): a randomised, non-inferiority, phase 3 trial and its extension study. Lancet Haematol. 2020;7:e196-e208.
  • 23. HuangC-E, Wu Y-Y, Hsu C-C, et al. Real-world experience with ropeginterferon-alpha 2b (Besremi) in philadelphia negative myeloproliferative neoplasms. J Formosan Med Assoc. 2021;120:863-873.
  • 24. Ronner L, Podoltsev N, Gotlib J, et al. Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis. Blood. 2020;135:1696-1703.
  • 25. Borowczyk M, Wojtaszewska M, Lewandowski K, et al. The JAK2 V617F mutational status and allele burden may be related with the risk of venous thromboembolic events in patients with Philadelphia-negative myeloproliferative neoplasms. Thromb Res. 2015;135:272-280.
  • 26. Masarova L, Yin CC, Cortes JE, et al. Histomorphological responses after therapy with pegylated interferon α-2a in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Exp Hematol Oncol. 2017;6:30.

Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği

Year 2025, Volume: 78 Issue: 1, 60 - 68, 31.03.2025
https://doi.org/10.4274/atfm.galenos.2025.36744

Abstract

Objectives: Several clinical studies have reported promising results in patients with essential thrombocythemia (ET) and polycythemia vera (PV)
treated with pegylated interferon alpha-2a (PEG-IFN-α-2a). In this study, we evaluated the efficacy and safety of PEG-IFN-α-2a in patients with
myeloproliferative neoplasms (MPNs) followed and treated in our clinic.
Materials and Methods: In this retrospective analysis, we present the outcomes of 39 patients diagnosed with MPNs (25 with ET, 13 with PV, 1 with
primary myelofibrosis) who received PEG-IFN-α-2a between 2014 and 2021.
Results: The average age of the participants was 49 years, ranging from 23 to 71. Most patients (92%) had received at least one prior cytoreductive
therapy. The median starting dose of PEG-IFN-α-2a was 126 mcg/week (range, 22.5-180 mcg/week), administered by self-injection. The median
duration of treatment was 24 months (range, 1-77). The overall response rates in patients with PV and ET were 84.6% and 92%, respectively. The
most common adverse events observed during the treatment period were fatigue (71%), myalgia (54%), and arthralgia (53%).
Conclusion: Our results suggest that PEG-IFN-α-2a remains a feasible treatment option, particularly for younger patients who wish to avoid
prolonged cytotoxic therapy.

Ethical Statement

Ethics Committee Approval: The study was approved by the Ankara University Faculty of Medicine Human Research Ethics Committee (date: 10.12.2021, approval no.: İ10-663-21).

Supporting Institution

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Project Number

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Thanks

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References

  • Tefferi A, Vainchenker W. Myeloproliferative neoplasms: molecular pathophysiology, essential clinical understanding, and treatment strategies. J Clin Oncol. 2011;29:573-582.
  • 2. Spivak JL. Myeloproliferative neoplasms. N Engl J Med. 2017;376:2168-2181.
  • 3. Platanias LC. Mechanisms of type-I- and type-II-interferon mediated signalling. Nature Reviews Immunol. 2005;5:375-386.
  • 4. Kiladjian J-J, Giraudier S, Cassinat B. Interferon-alpha for the therapy of myeloproliferative neoplasms: targeting the malignant clone. Leukemia. 2016;30:776-781.
  • 5. Gowina K, Jaina T, Kosiorek H, et al. Pegylated interferon alpha-2a is clinically effective and tolerable in myeloproliferative neoplasm patients treated off clinical trial. Leukemia Research. 2017;54:73-77.
  • 6. Quintas-Cardama A, Kantarjian H, Manshouri T, et al. Pegylated interferon alfa-2a yields high rates of hematologic and molecular response in patients with advanced essential thrombocythemia and polycythemia vera. J Clin Oncol. 2009;27:5418-5424.
  • 7. Gowin K, Thapaliya P, Samuelson J, et al. Experience with pegylated interferon alpha-2a in advanced myeloproliferative neoplasms in an international cohort of 118 patients, Haematologica. 2012;10:1570-1573.
  • 8. Utke Rank C, Bjerrum OW, Larsen TS, et al. Minimal residual disease after long-term interferon-alpha2 treatment: a report on hematological, molecular and histomorphological response patterns in 10 patients with essential thrombocythemia and polycythemia vera. Leuk Lymphoma. 2016;57:348-354.
  • 9. Barosi G, Besses C, Birgegard G, et al. A unified definition of clinical resistance/ intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia. 2007;21:277-280.
  • 10. Barosi G, Birgegard G, Finazzi G, et al. Response criteria for essential thrombocythemia and polycythemia vera: result of a European Leukemia Net consensus conference. Blood. 2009;113:4829-4233.
  • 11. Barosi G, Bordessoule D, Briere J, et al. Response criteria for myelofibrosis with myeloid metaplasia: results of an initiative of the European Myelofibrosis Network (EUMNET). Blood. 2005;106:2849-2853.
  • 12. Tefferi A, Cervantes F, Mesa R, et al. Revised response criteria for myelofibrosis: international working group-Myeloproliferative neoplasms Koyun et al. Myeloproliferative Neoplasm Pegylated Interferon Alpha-2a J Ankara Univ Fac Med 2025;78(1):60-68 68 research and treatment (IWG-MRT) and european LeukemiaNet (ELN) consensus report. Blood. 2013;122:1395-1398.
  • 13. Barosi G, Mesa R, Finazzi G, et al. Revised response criteria for polycythemia vera and essential thrombocythemia: an ELN and IWGMRT consensus project. Blood. 2013;121:4778-4781.
  • 14. Mascarenhas J, Kosiorek HE, Prchal JT, et al. Results of the myeloproliferative neoplasms-research consortium (MPN-RC) 112 randomized trial of pegylated interferon alfa-2a (PEG) versus hydroxyurea (HU) therapy for the treatment of high risk polycythemia vera (PV) and high risk essential thrombocythemia (ET) [Abstract]. Blood. 2018;132(Suppl 1):577.
  • 15. Masarova L, Patel KP, Newberry KJ, et al. Pegylated interferon alfa-2a in patients with essential thrombocythaemia or polycythaemia vera: a post hoc, median 83 month follow-up of an open-label, phase 2 trial. Lancet Haematol. 2017;4:e165-175.
  • 16. Yacoub A, Mascarenhas J, Kosiorek H, et al. Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood. 2019;134:1498-1509.
  • 17. Kiladjian JJ, Masse A, Cassinat B, et al. Clonal analysis of erythroid progenitors suggests that pegylated interferon alpha-2a treatment targets JAK2V617F clones without affecting TET2 mutant cells. Leukemia. 2010; 24:1519-1523.
  • 18. Verger E, Cassinat B. Clinical and molecular response to interferon-alpha mtherapy in essential thrombocythemia patients with CALR mutations. 2015;126:2585-2591.
  • 19. Kiladjian JJ, Cassinat B, Chevret S, et al. Pegylated interferon-alfa-2a induces complete hematologic and molecular responses with low toxicity in polycythemia vera. Blood. 2008;112:3065-3072.
  • 20. Crisà E, Cerrano M, Beggiato E et al. Can pegylated interferon improve the outcome of polycythemia vera patients? J Hematology Oncol. 2017;10:15.
  • 21. Marchioli R, Finazzi G, Specchia G, et al. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368:22-33.
  • 22. Gisslinger H, Klade C, Georgiev P, et al. Ropeginterferon alfa-2b versus standard therapy for polycythaemia vera (PROUD-PV and CONTINUATIONPV): a randomised, non-inferiority, phase 3 trial and its extension study. Lancet Haematol. 2020;7:e196-e208.
  • 23. HuangC-E, Wu Y-Y, Hsu C-C, et al. Real-world experience with ropeginterferon-alpha 2b (Besremi) in philadelphia negative myeloproliferative neoplasms. J Formosan Med Assoc. 2021;120:863-873.
  • 24. Ronner L, Podoltsev N, Gotlib J, et al. Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis. Blood. 2020;135:1696-1703.
  • 25. Borowczyk M, Wojtaszewska M, Lewandowski K, et al. The JAK2 V617F mutational status and allele burden may be related with the risk of venous thromboembolic events in patients with Philadelphia-negative myeloproliferative neoplasms. Thromb Res. 2015;135:272-280.
  • 26. Masarova L, Yin CC, Cortes JE, et al. Histomorphological responses after therapy with pegylated interferon α-2a in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Exp Hematol Oncol. 2017;6:30.
There are 26 citations in total.

Details

Primary Language English
Subjects Haematology
Journal Section Research Article
Authors

Derya Koyun 0000-0003-3970-2010

Güldane Cengiz Seval 0000-0001-9433-2054

Sinem Civriz Bozdağ This is me 0000-0001-8359-7794

Selami Koçak Toprak 0000-0001-7717-5827

Pervin Topçuoğlu 0000-0002-4834-3585

Önder Arslan 0000-0002-6164-4059

Muhit Özcan 0000-0002-1326-1918

Project Number -
Submission Date December 7, 2024
Acceptance Date February 26, 2025
Publication Date March 31, 2025
Published in Issue Year 2025 Volume: 78 Issue: 1

Cite

APA Koyun, D., Cengiz Seval, G., Civriz Bozdağ, S., … Toprak, S. K. (2025). Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 78(1), 60-68. https://doi.org/10.4274/atfm.galenos.2025.36744
AMA Koyun D, Cengiz Seval G, Civriz Bozdağ S, et al. Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. March 2025;78(1):60-68. doi:10.4274/atfm.galenos.2025.36744
Chicago Koyun, Derya, Güldane Cengiz Seval, Sinem Civriz Bozdağ, Selami Koçak Toprak, Pervin Topçuoğlu, Önder Arslan, and Muhit Özcan. “Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği Ve Güvenliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78, no. 1 (March 2025): 60-68. https://doi.org/10.4274/atfm.galenos.2025.36744.
EndNote Koyun D, Cengiz Seval G, Civriz Bozdağ S, Toprak SK, Topçuoğlu P, Arslan Ö, Özcan M (March 1, 2025) Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78 1 60–68.
IEEE D. Koyun, G. Cengiz Seval, S. Civriz Bozdağ, S. K. Toprak, P. Topçuoğlu, Ö. Arslan, and M. Özcan, “Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 1, pp. 60–68, 2025, doi: 10.4274/atfm.galenos.2025.36744.
ISNAD Koyun, Derya et al. “Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği Ve Güvenliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78/1 (March2025), 60-68. https://doi.org/10.4274/atfm.galenos.2025.36744.
JAMA Koyun D, Cengiz Seval G, Civriz Bozdağ S, Toprak SK, Topçuoğlu P, Arslan Ö, Özcan M. Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78:60–68.
MLA Koyun, Derya et al. “Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği Ve Güvenliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 1, 2025, pp. 60-68, doi:10.4274/atfm.galenos.2025.36744.
Vancouver Koyun D, Cengiz Seval G, Civriz Bozdağ S, Toprak SK, Topçuoğlu P, Arslan Ö, et al. Gerçek Yaşam Çalışması: Miyeloproliferatif Neoplazm Hastalarında Pegile İnterferon Alfa2a’nın Etkinliği ve Güvenliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78(1):60-8.