How I use peg-IFN-α in practice
| . | Safety . | Efficacy . |
|---|---|---|
| Before treatment | • Exclusion of contraindications (per drug label) • Search for potential cardiac or ophthalmologic abnormalities • Screen for autoimmunity (at least antinuclear Ab) and TFT | • Measure spleen size by echography • Assess driver mutation allele burden • If possible screen for additional mutations by NGS |
| Treatment initiation | • Start at low dose | • Titration until CHR |
| peg-IFN-α2a | 45 µ/wk | By 45 µ/2wk Max dose 180 µ/wk |
| ropegIFN-α2b | 100 µ/2wk | By 50 µ/2wk Max dose 500 µ/2wk |
| Monitoring during treatment | • Screen for mood disturbances, thyroid dysfunction, type 1 diabetes • CBC/mo • LFT, TFT/6 mo | • CBC/mo • Spleen size and mutation/y |
| Dose adjustments | According to potential toxicities | Progressive decrease after 1 year in case of lasting CHR |
| pegIFN-α2a | By 45 µ per injection every 6 months down to 45 µ/wk, then by expanding interval to every 2wk | |
| ropegIFN-α2b | By 50 µ per injection every 6 months down to 100 µ/2wk, then by expanding interval to every 4wk | |
| Discontinuation | In case of intolerance | In patients with at least 2 years of continuous CHR on IFN and JAK2 V617F VAF <10% |
| . | Safety . | Efficacy . |
|---|---|---|
| Before treatment | • Exclusion of contraindications (per drug label) • Search for potential cardiac or ophthalmologic abnormalities • Screen for autoimmunity (at least antinuclear Ab) and TFT | • Measure spleen size by echography • Assess driver mutation allele burden • If possible screen for additional mutations by NGS |
| Treatment initiation | • Start at low dose | • Titration until CHR |
| peg-IFN-α2a | 45 µ/wk | By 45 µ/2wk Max dose 180 µ/wk |
| ropegIFN-α2b | 100 µ/2wk | By 50 µ/2wk Max dose 500 µ/2wk |
| Monitoring during treatment | • Screen for mood disturbances, thyroid dysfunction, type 1 diabetes • CBC/mo • LFT, TFT/6 mo | • CBC/mo • Spleen size and mutation/y |
| Dose adjustments | According to potential toxicities | Progressive decrease after 1 year in case of lasting CHR |
| pegIFN-α2a | By 45 µ per injection every 6 months down to 45 µ/wk, then by expanding interval to every 2wk | |
| ropegIFN-α2b | By 50 µ per injection every 6 months down to 100 µ/2wk, then by expanding interval to every 4wk | |
| Discontinuation | In case of intolerance | In patients with at least 2 years of continuous CHR on IFN and JAK2 V617F VAF <10% |
Ab, antibodies; CBC, complete blood count; LFT, liver function tests; NGS, next-generation sequencing; TFT, thyroid function tests.