Cytogenetic remission 10 years after the start of monotherapy with interferon α-2b in elderly chronic myelogenous leukemia

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  • Umeda Masanori
    First Department of Internal Medicine, Toho University School of Medicine
  • Katoh Masako
    First Department of Internal Medicine, Toho University School of Medicine
  • Arai Chiaki
    First Department of Internal Medicine, Toho University School of Medicine
  • Iijima Kimiko
    First Department of Internal Medicine, Toho University School of Medicine

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Other Title
  • インターフェロンα-2b単独投与にて治療開始10年後に細胞遺伝学的寛解を呈している高齢者慢性骨髄性白血病の1例
  • 症例報告 インターフェロンα-2b単独投与にて治療開始10年後に細胞遺伝学的寛解を呈している高齢者慢性骨髄性白血病の1例
  • ショウレイ ホウコク インターフェロン アルファ 2b タンドク トウヨ ニテ チリョウ カイシ 10ネンゴ ニ サイボウ イデンガクテキカンカイ オ テイシテ イル コウレイシャ マンセイ コツズイセイ ハッケツビョウ ノ 1レイ
  • Cytogenetic remission 10 years after the start of monotherapy with interferon α-2b in elderly chronic myelogenous leukemia

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Abstract

A 69-year-old man was found to have leukocytosis and a bleeding tendency, when he underwent surgery for hemorrhoids in November 1992, at the age of 69. The patient was referred to our department for further examination, and was admitted on December 4. On admission, he had hepatomegaly (5cm) and splenomegaly (12cm). Laboratory data on admission showed that the leukocyte count was 173, 400/μl, erythrocyte count, 314×104/μl, hemoglobin level, 10.5g/dl, hematocrit value, 29.7%, and platelet count, 14.4×104/μl, respectively. Peripheral hemogram revealed neutrophilia with a shift to the left to promyelocytes, and the positivity of neutrophil alkaline phosphatase (NAP) was very low. The bone marrow was hyperplastic with a high M/E ratio (5.8). As the chromosome analysis revealed that he had 9: 22 translocation in all 20 karyotypes, chronic myelogenous leukemia in the chronic phase, was diagnosed. After the daily intramuscular administaration of 9 megaunits interferon α-2b was started on December 9, 1992, his leukocyte count stabilized between 5, 000 and 8, 000/μl. Thereafter, intramuscular administration of IFNα has been continued regularly almost twice a week at the outpatient clinic until now. The leukocyte count ranges from 3, 000 to 6, 000/ml and he is asymptomatic. In April 1995, complete cytogenetic response was achieved 28 months after the start of interferon α therapy. The recent bone marrow chromosomes examination showed Philadelphia-negative metaphases until now. December, 2002, although major bcr-abl still remains positive.<br>This case suggests that treatment with interferon a may still be useful in some elderly patients with chronic myelogenous leukemia.

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