Pegylated Interferon Alpha-2b in Early Primary Myelofibrosis

Inclusion Criteria

• •\- Patients must meet laboratory, and bone marrow histological criteria for primary myelofibrosis as defined by World Health Organization (WHO) diagnostic criteria as follows:
• •WHO diagnostic criteria for PMF Proposed Criteria for PMF Major Criteria
• •1. Presence of megakaryocyte proliferation and atypia, usually accompanied by either reticulin and/or collagen fibrosis, or, in the absence of significant reticulin fibrosis, the megakaryocyte changes must be accompanied by an increased bone marrow cellularity characterized by granulocytic proliferation and often decreased erythropoiesis (ie. prefibrotic cellular-phase disease)
• •2. Not meeting WHO criteria for Polycythemia Vera (PV), Chronic Myeloid Leukemia (CML), Myledysplastic Syndrome (MDS), or other myeloid neoplasm
• •3. Demonstration of JAK2617V\>F or other clonal marker (e.g. MPL515W\>L/K), or in the absence of a clonal marker, no evidence of bone marrow fibrosis due to underlying inflammatory or other neoplastic disease
• •Minor Criteria
• •1. Leukoerythroblastosis
• •2. increase in serum Lactase Dehydrogenase (LDH)
• •3. Anemia
• •4. Palpable splenomegaly
• •* Patients must have Low or Intermediate 1 stage of disease as defined by International Working Group (IWG) risk stratification of primary myelofibrosis in the dynamic international prognostic scoring system (DIPSS). In addition, they must show some active hematopoiesis with a cellularity of at least 15%, irrespective of the degree of reticulin and/or collagen fibrosis as defined by Manoharan criteria.
• •* Patients should NOT have had prior therapy for primary myelofibrosis. This includes treatment with cytoreductive drugs (Hydroxyurea), immunomodulatory drugs (thalidomide, lenalidomide, pomalidomide), JAK2 inhibitors, or other therapies specifically for myelofibrosis. If they received these classes of drugs for indications other than PMF, treatment should be discontinued at least 6 weeks prior to randomization.
• •* Eastern Cooperative Oncology Group (ECOG) performance status \< 2
• •* Patients must have normal organ and marrow function as defined below:
• •* White blood cell (WBC) ≥ 3,000/microL
• •* Absolute Neutrophil Count (ANC) ≥ 1,500/microL
• •* Platelets ≥ 100,000//microL
• •* Total bilirubin within normal limits
• •* Aspartate aminotransferase - serum glutamic oxaloacetic transaminase (AST(SGOT)) and alanine aminotransferase - serum glutamic pyruvic transaminase (ALT(SGPT)) less than or equal to 2.5 X upper limit of normal
• •* Creatinine Clearance ≥ 50 ml/min
• •* The effects of peg-IFNα-2b on the developing human fetus at the recommended therapeutic dose are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
• •* Ability to understand and the willingness to sign a written informed consent document.