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Polycythemia vera is a myeloproliferative disease, which, if untreated, leads to thrombohemorrhagic complications and eventually to progressive myelofibrosis, anemia, and splenomegaly. Two newly available drugs, interferon alfa and imatinib mesylate, may alter the course of this disease. Used as single agents, each produces lasting remissions in about 75% of patients with polycythemia vera. Of significance, change in JAK2 expression has been reported after treatment with both agents.

Tubuloreticular structures were induced in human umbilical vein endothelial cells cultured in media containing recombinant interferon alfa and beta but not in media containing recombinant interferon gamma or other agents that induce interferon, such as 5-bromodeoxyuridine or polyinosinic-polycytidylic acid. Recombinant interferon beta induced tubuloreticular structures in endothelial cells at a lower concentration and in a greater percentage of cell sections than recombinant interferon alfa. This report of tubuloreticular structures being induced in vitro in nonlymphoid cells provides evidence that interferon is the substance that causes the formation of tubuloreticular structures in endothelial cells in vivo.

Following reports that recombinant interferon alfa (rIFN alpha), besides inducing clinical and hematologic remission in polycythemia vera (PV), can also resolve intractable pruritus, we used rIFN alpha to treat 13 PV patients complaining of severe pruritus refractory to conventional treatment (venesection and/or cytostatics). rIFN alpha was administered intramuscularly three times a week at a dosage of 3.0 x 10(6) U. Eight patients (61.5%) reported a > or = 50% reduction of pruritus, which occurred within 2-8 weeks from the start of rIFN alpha treatment, leading to a substantial improvement in their quality of life. Three patients had to stop rIFN alpha within the first month of therapy because of unacceptable side effects. Thus rIFN alpha seems to be capable of providing considerable relief of otherwise intractable pruritus in a good proportion of PV patients.

Recombinant interferon alfa, a natural product with growth inhibitory capabilities, has been demonstrated for the first time to have significant therapeutic efficacy in controlling the red cell mass in patients with the myeloproliferative disease polycythemia vera. The starting dose was 3.0 X 10(6) U three times a week, subcutaneously (SC). In three patients the dose required was 5.0 X 10(6), U five times a week, SC. Side effects were easily tolerated. The striking advantage in the use of this drug is its presumed absence of antileukemic effect. Further evaluation is necessary, but the initial responses are encouraging.

Excerpt For two decades, therapy for viral hepatitis has included alpha-interferon, but only this year was the drug licensed for treatment of chronic non-A, non-B hepatitis. The licensing of the dr...

To the Editors: Zielinski and Lawrence (1) reported the case of a patient with the hypereosinophilic syndrome who was successfully treated with interferon-a. Independently of their studies, we init...

Chronic hepatitis C (non-A, non-B hepatitis) is a common and often progressive viral liver disease. To assess the efficacy of therapy with the antiviral agent interferon alfa, we randomly ...

The therapeutic potential of interferon has been reviewed twice before in these columns.1 , 2 After an initial period of limited availability of the natural material, followed by a period of unrealistic expectations when cloning made interferon readily available, the real usefulness of interferon is just beginning to be understood. Last year, the U.S. Food and Drug Administration licensed two firms to sell recombinant interferon alfa for the treatment of hairy-cell leukemia. Its local administration in condylomata acuminata is the application most likely to be licensed next in the United States. Why is there such a limited series of uses despite interferon's . . .

A patient with debilitating hairy cell leukemia and documented Mycobacterium avium intracellulare infection unresponsive to standard antituberculous therapy who was treated with alpha-interferon is described. A rapid clinical response with correction of underlying pancytopenia and eradication of the atypical mycobacteria infection was found. No deleterious effects from alpha-interferon therapy were found. The associated resolution of anergy and the sterilization of bone marrow suggest that the reversal of host cellular immune defects led to the eventual control of this patient's infection.

Excerpt Cold agglutinin disease may be classified as primary or secondary. Monoclonal IgM (occasionally IgG or IgA) proteins with the ability to bind to erythrocytes below body core temperature are...