The occurrence of autoimmune disease in patients receiving alpha-interferon (a-IFN) therapy has been reported in several studies; these include autoimmune thyroiditis, thrombocytopenia, anemia, exacerbation of psoriasis, and the occurrence of sarcoidosis. The primary mechanism presumably is the emergence of autoantibodies to various structural proteins or receptors. Two studies have recently shown that a significant percentage of patients treated with recombinant alpha-interferon (r a-IFN) do form autoantibodies. The authors report six additional cases of development or exacerbation of autoimmune phenomena in patients receiving a-IFN therapy. Five of these patients developed symmetric polyarthropathies and the sixth had thyroiditis. The presence of a history of underlying autoimmune disease or baseline serologic abnormalities in five of these patients, including the patient who developed thyroiditis, suggests that a-IFN treatment can lead to the exacerbation of an underlying subclinical autoimmune process. Cancer 65:2237-2242,1990.
LPHA-INTERFERON (a-IFN) has established antitu-
A mor activity in a number of malignancies including chronic myelogenous leukemia, m e l a n ~m a , ~-~ renal cell ~a n c e r , ~, ~ non-Hodgkin's l y m p h ~m a , ~. ~ and multiple myeloma.'O~l' Now a-IFN is considered to be standard therapy for patients with hairy cell l e ~k e m i a , ' ~-' ~ and for acquired immune deficiency syndrome (AIDS)-associated Kaposi's sarcoma. l5 The common side effects associated with its use include fevers, chills, myalgia, arthralgia, fatigue, mild reversible bone marrow suppression, nausea, vomiting, and diarrhea.16 There have been reports of transient exacerbations of probable autoimmune diseases associated with recombinant human (rH) a-IFN therapy. Most of these reports have described autoimmune thyroiditis or autoimmune thrombocytopenia although autoimmune hemolytic anemia, exacerbation of psoriasis, the occurrence of sarcoidosis, and possible cellmediated suppression of hematopoiesis have also been re-Two recent studies have shown a high fre-I