Interferon-a as maintenance therapy in patients with multiple myeloma

Background: The effect of interferon-a 2b (IFN-a-2b) on progression-free and overall survival aswell as quality of life (QoL) was studied in mainly elderly patients with multiple myeloma (MM),who reached a plateau phase after melphalan/prednisone induction.Patients and methods: In an open phase III trial, 262 patients, median age 69 years (range 34–91),received at least 10 monthly courses of melphalan/prednisone followed by response evaluation. Pla-teau phase was reached by 128 patients. Next, 90 patients were randomized between IFN-a-2b andno maintenance therapy. Reasons for non-randomization were: refusal (18), concomitant disease(nine), protocol violation (six), WHO performance status >2 (four) and allogeneic transplantation(one)Results: At a median follow-up from diagnosis of 97 months (0–140) for those patients alive,IFN-a-2b therapy was associated with improved progression-free survival (median 13.5 versus8.4 months from randomization), although this did not translate in a better overall survival (41 ver-sus 38.4 months). One-third of patients discontinued IFN-a due to toxicity. No differences wereobserved between patient groups in QoL.Conclusions: IFN maintenance therapy in MM prolongs progression-free survival and, provided thatthe burden of toxicity is not too high, does not adversely affect QoL.Key words: interferon-a, maintenance therapy, multiple myeloma