La Revue de médecine interne
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IFN alpha are cytokines used for a number of years in the treatment of certain hemopathies, i.e. of a myeloid and lymphoid etiology. IFN alpha are a family of polypeptides produced by eukaryote cells in response to various stimulant agents. The first trials using this cytokine in humans were carried out by H. Strander in the years 1965-1970. IFN alpha contain anti-viral, anti-proliferative and immunomodulatory properties. The access of clinicians to IFN alpha molecules, in addition to elements produced by genetic engineering for approximately the past 20 years, has permitted a number of therapeutic trials to be carried out. In hematology the clinical interest of IFN alpha was primarily in chronic myeloid and lymphoid proliferating syndromes. Certain indications have to date been well demonstrated. However, the impact of IFN alpha on therapeutic care of certain hemopathies as compared to conventional treatment remains controversial. At the same time, the frequency of side effects from treatment with IFN alpha and its cost should be taken into consideration. ⋯ The future of IFN alpha use in the treatment of hemopathies appears to be linked to its association with new treatments, an association, however, where its efficacy and superiority should be demonstrated. This is the case in chronic myeloid leukemia where IFN alpha could be associated with aracytine or the inhibitors of tyrosine kinase. Also, in the treatment of malignant non-Hodgkin's lymphomas as well as the studies concerning the association between IFN alpha and monoclonal antibodies, in particular antibody anti-CD 20.
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Since the discovery of hepatitis C (HCV), the efficacy of treatment has significantly progressed using standard mono-therapy: with Interferon alpha (IFN) during six months we obtained approximately 10% sustained response and currently with the association of pegylated IFN and Ribavirin a 55% sustained response was achieved. ⋯ Despite the considerable and rapid progress obtained in the therapeutic treatment of infection due to HCV and HBV a number of unknown factors remain, which warrants further trials, in particular to evaluate the efficacy as well as the tolerance of the antiviral agent association.