Standard treatment of patients with chronic myelogenous leukemia in chronic phase consists of allogeneic stem cell transplantation or interferon. Treatment with interferon has been demonstrated in several clinical trials to prolong survival when compared to other single agent chemotherapy treatment regimens. In order to determine whether the addition of chemotherapy to interferon could improve the survival of patients, doctors in France performed a large clinical study directly comparing treatment with interferon to treatment with interferon plus chemotherapy.
In this clinical study, 745 patients less than 70 years of age were treated with a standard regimen of interferon. Half of the patients were additionally treated with monthly administration of cytarabine chemotherapy. Patients treated with the combination of cytarabine and interferon were more likely to achieve a complete hematologic remission or a major cytogenetic response. Five years from initiation of treatment, 70% of patients treated with interferon plus cytarabine survived, compared to only 58% of patients treated with interferon alone. Importantly, the addition of cytarabine did not increase the likelihood that patients stopped treatment from side effects.
In summary, the results of this clinical trial demonstrate that the addition of monthly cytarabine chemotherapy treatment to a standard regimen of interferon can improve the survival of patients with chronic phase chronic myelogenous leukemia without increasing the toxicity of the interferon treatment. The combination of cytarabine and interferon is a standard treatment option for patients unable to pursue curative treatment with allogeneic stem cell transplantation. (Proceedings of American Society of Clinical Oncology, Vol 18, Abstract 23, 1999.)
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