NEW APPROACHES TO THERAPY OF CLASSICAL PH-NEGATIVE MYELOPROLIFERATIVE DISEASES: THE EXPERIENCE OF EARLY THERAPY WITH CEPEGINTERFERON ALPHA-2B

• Main Authors: A. S. Polyakov, Y. A. Noskov, V. V. Tyrenko, A. S. Lapshova, A. V. Kovalev
• Format: Article
• Language: Russian
• Published: ABV-press 2018-05-01
• Series: Onkogematologiâ
• Subjects: : myeloproliferative neoplasms; mpn; polycythemia vera; essential thrombocythemia; myelofibrosis; pegylated interferon alpha; cepeginterferon alpha-2b
• Online Access: https://oncohematology.abvpress.ru/ongm/article/view/274

Background. Even 100 years after the first attempts to introduce the chemotherapeutic approaches (in 1918) and despite the completely formed notions of myeloproliferative diseases as a group of malignant neoplasms, in the majority of patients with Ph-negative myeloproliferative neoplasms (MPN), a symptomatic, in fact, therapy approach – the impact on peripheral blood indices and nonspecific thromboprophylaxis – is allowed. The limitations of classical cytoreduction and current targeted therapy, as well as the conviction of most specialists in the impossibility of adequately containment of disease progression, continue to be the main factors that keep physicians from the early start of pathogenetic therapy.Objective: to study the efficacy and safety of cepeginterferon alpha-2b (cePEG-IFN alpha-2b) in early (non-risk-adjusted) therapy of classical Ph-negative myeloproliferative neoplasms in initial use and after therapy with other pegylated interferons (PEG-IFN).Materials and methods. Twenty seven patients with polycythemia vera or essential thrombocythemia, without considering risk, received cePEG-IFN alpha-2b: initially, or after 6 or 12 months of other pegylated interferon therapy, in a dosage of 200 μg per week, with a decrease to 100 μg per week if 2 degree hematological toxicity developed. Hematological and molecular responses were assessed. Follow-up – from 20 to 46 months.Results. In all groups, a hematologic response comparable in depth and dynamics, as well as a molecular response as a steady decrease in the JAK2V617F allelic load, was achieved. There was no effect on the results of change to therapy with cePEG-IFN alpha-2b. CePEGIFN alpha-2b showed less dose-limiting toxicity for neutropenia and better pharmacoeconomic feasibility.Discussion. New data about mechanisms of antiproliferative effects of interferon alfa preparations are given. The pharmacological advantages of cePEG-IFN alpha-2b are discussed: superiority in pharmacokinetic parameters, the presence of one position isomer purity of the drug substance, the convenience of self-application. Conclusion. Early administration of an effective pathogenic therapy is an independent preventive measure to prevent the MPN progression and complications development. The use of cePEG-IFN alpha-2b may help to improve the care of MPN patients.