Role of alpha interferon in multiple myeloma

Interferons are soluble proteins produced by cells in response to viruses. Although they were first introduced as therapeutic agents for myeloma in 1979 their exact role in the management of myeloma remains to be precisely defined. Interferons have both anti-proliferative and immune regulation effects, but the predominant mode of action of interferons in myeloma is still unclear. Recombinant alpha interferon has been used in clinical trials as a single induction agent, co-induction agents with combination chemotherapy, as salvage therapy, and as therapy to maintain plateau phase after conventional chemotherapy or complete remission after auto or allogeneic transplantation. Interferon as a single induction or co-induction agent with other forms of chemotherapy appears to be of only minimal benefit in myeloma. However, its role as maintenance agent has received a great deal of interest and investigation. Its most beneficial role would appear to be in those patients who have had good responses to either conventional therapy or to bone marrow transplantation and the beneficial role of interferon in the maintenance of plateau phase is gaining credence. Its maximum advantage appears to be in patients with initial good response who have obtained plateau phase, or in patients who have developed complete remission after auto transplantation. It also has a role as salvage treatment in refractory patients with myeloma where the combination of interferon and dexamethazone may be a useful therapeutic modality.