CR: complete response; PR: partial response; NR: not reported.

CR: complete response; PR: partial response; NR: not reported.

to the general population, and for patients with hematologic neoplasms, it was 40 times the expected frequency. However, other single institution series indicate a risk equal to the general population, but with an increase in lymphoid neoplasms.20

The toxicity profile of interferon includes a mild influenza-like syndrome. This syndrome occurs in 95% of patients and is characterized by fevers, myalgias, and fatigue; it improves after 2-4 weeks despite the continuation of therapy and responds well to acetaminophen. Cutaneous side effects, including both generalized rash as well as injection site reactions, are noted in approximately 50% of the patients. Central nervous system side effects include depression and somnolence. Although transient myelosuppression is observed during the first 2 months of therapy, patients treated with interferon have fewer incidences of infections compared to an untreated cohort.52 Reversible liver enzyme abnormalities are observed in 20-30% of the patients.

In summary, interferon-a remains a palliative treatment strategy without observed complete eradication of the disease. Compared to nucleoside analogs, the response is usually slower and only rarely complete. It is now rarely the initial treatment of choice, but can be considered for hairy cell leukemia patients with active uncontrolled infection, for a disease which has relapsed or is refractory to first-line therapy, or in those with an unacceptably high risk for febrile neutropenia. This may include elderly patients with medical comorbidi-ties, which preclude the use of purine analogs, or those with significant renal insufficiency. In addition, although experience with interferon-a in pregnant patients with hairy cell leukemia is limited, safety has been demonstrated when used in similar patients with chronic myelogenous leukemia.

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