Introducere. Mielofibroza primară (MFP) este un neoplasm clasic mieloproliferativ cromozom Philadelphia negativ cu evoluția ireversibilă și prognostic nefavorabil. Clinic se manifestă prin semne constituționale, splenomegalie și dereglări în hemoleucogramă. Managementul acestui neoplasm complicat este în continuă perfecționare. Scopul lucrării. Analiza eficacității tratamentului cu interferon alfa la pacienți cu MFP în a doua linie după agent anti neoplazic citoreductiv. Material și metode. A fost efectuat un studiu retrospectiv clinico-analitic în baza datelor din departamentul hematologic al Institutului Oncologic. La moment la evidență sunt 450 de pacienți cu MFP. Imunoterapia a fost inițiată în 16 cazuri, dintre care doar 8 pacienți au primit interferon alpha ca a doua linie după tratament citoreductiv cu hidroxicarbamid. Rezultate. În 37,5% a fost obținut răspuns clinico-hematologic prin ameliorarea stării generale, normalizarea hemoleucogramei și micșorarea dimensiunilor a splinei. Tratament a fost suportat nesatisfăcător în 25% din care motiv a fost întrerupt. Din cauza lipsei răspunsului terapeutic adecvat și persistența semnelor constituționale, 12,5 % au fost transferați la a 3-a linie de tratament specific. În 12,5% de cazuri pacienți au avut tendința spre normalizare a hemoleucogramei, dar au refuzat imunoterapia din motive personale. Concluzii. Studiu efectuat demonstrează că interferon alfa poate fi administrat în tratamentul MFP ca a doua linie după utilizarea altor agenți citoreductivi, ramând o indicație perfectă pentru pacienți tineri.

Background. Primary myelofibrosis (PMF) is a classic Philadelphia chromosome negative myeloproliferative neoplasm with irreversible evolution and unfavorable prognosis. Clinically, it is manifested by constitutional symptoms, splenomegaly, and abnormalities in the complete blood count (CBC). The management of this complicated neoplasm is constantly improving. Objective of the study. Analysis of the effectiveness of second-line interferon alfa therapy in patients after cytoreductive chemotherapy. Material and methods. A clinical-analytical retrospective study was performed based on the data from the hematology department of the Oncological Institute. There are currently 450 patients with PMF. Immunotherapy was initiated in 16 cases and only 8 patients received interferon alpha as a second line after cytoreductive treatment with hydroxyurea. Results. A clinical-hematological response was attained in 37.5% of cases by improving overall wellness, bringing the CBC back to normal, and minimizing the spleen. 25% of patients did not tolerate the treatment satisfactorily, so it was discontinued. 12.5% of patients were transferred to the third line of specific therapy due to an insufficient therapeutic response and persistent constitutional problems. Patients who had a good chance of obtaining their CBC back to normal in 12.5% of cases decided to refuse immunotherapy for personal reasons. Conclusions. The study demonstrates that interferon alfa can be used as a second-line treatment for MFP afterward using other cytoreductive medicines and is an ideal option for young patients.Background. Primary myelofibrosis (PMF) is a classic Philadelphia chromosome negative myeloproliferative neoplasm with irreversible evolution and unfavorable prognosis. Clinically, it is manifested by constitutional symptoms, splenomegaly, and abnormalities in the complete blood count (CBC). The management of this complicated neoplasm is constantly improving. Objective of the study. Analysis of the effectiveness of second-line interferon alfa therapy in patients after cytoreductive chemotherapy. Material and methods. A clinical-analytical retrospective study was performed based on the data from the hematology department of the Oncological Institute. There are currently 450 patients with PMF. Immunotherapy was initiated in 16 cases and only 8 patients received interferon alpha as a second line after cytoreductive treatment with hydroxyurea. Results. A clinical-hematological response was attained in 37.5% of cases by improving overall wellness, bringing the CBC back to normal, and minimizing the spleen. 25% of patients did not tolerate the treatment satisfactorily, so it was discontinued. 12.5% of patients were transferred to the third line of specific therapy due to an insufficient therapeutic response and persistent constitutional problems. Patients who had a good chance of obtaining their CBC back to normal in 12.5% of cases decided to refuse immunotherapy for personal reasons. Conclusions. The study demonstrates that interferon alfa can be used as a second-line treatment for MFP afterward using other cytoreductive medicines and is an ideal option for young patients.