Interferons as the First Choice of Cytoreduction in Essential Thrombocythemia and Polycythemia Vera

Authors: Joan How MD1 and Gabriela Hobbs MD2
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  • 1 Division of Hematology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School; and
  • | 2 Department of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Interferons are cytokines with immunomodulatory properties that have been used in the treatment of myeloproliferative neoplasms (MPNs) for decades. However, their widespread use has been hampered by their adverse effect profile and difficulty with administration. Recently there has been a resurgence of interest in the use of interferons in MPNs given the development of pegylated formulations with improved tolerability. Currently, treatments for polycythemia vera (PV) and essential thrombocythemia (ET) are targeted toward decreasing the risk of thrombotic complications, because there are no approved therapies that are known to modify disease. However, recent data on interferons in MPNs have suggested the potential for disease-modifying activity, including the achievement of molecular remission and sustained clinical response. This development has led to the question of whether interferons should move forward as the preferred frontline cytoreductive agent for ET and PV, and challenges the criteria currently used to initiate therapy. We review randomized controlled trial data evaluating interferon’s efficacy and tolerability in patients with ET and PV. We then consider the data in the context of interferon’s known advantages and disadvantages to address whether interferons should be the first choice for cytoreductive treatment in patients with ET and PV.

Submitted February 18, 2022; final revision received April 12, 2022; accepted for publication May 2, 2022.

Disclosures: Dr. Hobbs has disclosed giving a presentation to PharmaEssentia on the use of ropeginterferon. Dr. How has disclosed having no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors.

Correspondence: Joan How, MD, Division of Hematology, Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, Hematology-SR312, Boston, MA 02115. Email: jhow@bwh.harvard.edu
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