Hi,
My doctor has recommended me to start Glivec (400mg) + Interferon (Intron A - Interferon Alfa-2b) therapy to treat CML (chronic stage).
Unfortunately Intron A seems to be unavailable in the country where I live now. My doctor has asked me to try to source it from elsewhere if possible.
Can you please recommend any source from where I can obtain Intron A - Interferon alfa-2b medicine using the prescription given by my doctor?
Thank you. Please help.
Regards,
Luke
Hi Kirk,
My doctor believes that Interferon along with Glivec will provide a better response and bring down the numbers faster than only using Glivec.
Hence he thinks that it is essential to my treatment. Please recommend how I can obtain Interferon medicine in this case.
Thank you.
Regards,
Luke.
Hi Luke,
The jury is out on interferon in combination with a TKI, but here is a useful summary of a French trial which may well be what your doctor is basing his opinion on:
https://www.cmladvocates.net/faqs/3-news/newsflash/220-ash2012-report#in...
It's not commonly seen in clinic, but it's not that "out there" and pegylated interferon is well tolerated. When faster responses are desired (remember, fast isn't the goal ... getting over the MMR line is the goal, however long it takes to get there) 2nd generation TKIs such as dasatinib or nilotinib are usually used.
David.
Hydrea (hydroxycarbamide / hydroxyurea) basically kills blood cells. It doesn't do much more than that. But it's really effective at getting blood counts down from sky-high levels. It won't treat CML, but it can help bring blood levels into a more manageable state.
Interferon is maybe best thought of as an immune system booster. Before we had TKIs it was all we really had to treat CML. It wasn't great, but better than nothing. So the theory goes that adding to to a TKI regimen might give better results. This seemed to be spoken about quite a lot a few years ago but in the last couple of years has been fairly quiet. I think in reality the TKIs work really well and the focus for most people who do well is taking the minimum dosage needed.
David.
Hi Luke and welcome,
the problem with interferon (IFN) is that it causes a high degree of intolerable side effects in most people. This is why the majority of CML expert clinician in the UK - and probably elsewhere - no longer use it in the form that you are looking for.
In the pre-TKI era, it was used but the percentage of people that responded well was very low - I think as low as 13% - so given the fairly horrendous side effects it did not offer much of a trade-off.
However, there have been a few clinical studies that have combined TKI therapy with low dose IFN-a and more recently a pegylated form of low dose IFNa .... see clinical trial of imatinib combined with PegIFN here: Tolerability and efficacy of pegylated interferon-α-2a in combination with imatinib for patients with chronic-phase chronic myeloid leukemia
Sandy
I took a combination of 400mg Gleevec and Interferon for @ 6 months in 2005. While my PCR levels returned to undetectable, the side effects were pretty horrible. I felt like I had a bad case of the flu. I am also left with neuropathy in my legs. I know that Dr. Druker at OHSU doesn't recommend this combination as there are newer and better medicines at this point. I would certainly advise you to see a CML specialist and get a second opinion.
Thank you, David.
I cannot take Nilotinib and Dasatinib since I suffer from heart disease.
Hence my doctor would like to start me on Glivec + IntronA interferon. He believes that this is the safest course of action in this case.
Hence I am looking for obtaining the interferon medicine from elsewhere since it is not available here.
Please let me know where I could get IntronA interferon from with my doctor's prescription.
Regards,
Luke.
Thank you, Sandy.
My doctor would like to start me on Glivec + Intron A which is similar to the clinical trial of imatinib combined with PegIFN study.
I cannot take Nilotinib and dasatinib since I suffer from heart disease.
Please let me know where I could obtain Intron A with my doctor's prescription.
Regards,
Luke.
Luke, I hope you're not waiting to start treatment with Glivec until you can get the Interferon. I don't have any idea how to get a prescription filled from another country. It seems the pharmacy that supplies the Glivec might have some suggestions?
Best of luck,
Kirk
Luke, look into pegylated interferon. It has a much much lower side effect profile than "normal" interferon, and it is the type of interferon that has been studies with Imatinib the most. But either way as Kirk says, do not hold off taking imatinib while waiting for interferon. It still seems an odd idea, to be honest.
Have you spoken to your doctor about bosutinib? It could be an option for you too.
David.
Thank you, David.
My doctor will start me on imatinib first without waiting for the interferon.
Do you know where and how I can obtain pegylated interferon with a doctor's prescription? Is it available in UK? Or anywhere else?
Regards,
Luke.
