Successful re‐treatment of an anti‐interferon resistant polycythaemia vera patient with lymphoblastoid interferon‐αN1 and in vitro studies on the specificity of the antibodies

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Abstract
A polycythaemia vera patient who initially responded to recombinant IFN‐α2 (rIFN‐α2) treatment developed neutralizing antibodies (NA) against it and lost response. Despite raising the dose, clinical resistance persisted and NA increased when two alternative rIFN‐α2 preparations were used. When treatment was switched to lymphoblastoid IFN‐α (lyIFN‐αN1), clinical response was restored and maintained. During re‐treatment, NA specific for the earlier rIFN‐α2 preparations redeveloped and cross‐reacted extensively with each other but not with ‘whole’lyIFN‐αN1 and only minimally with the lyIFN‐α2 subtype within it. These findings demonstrate the relevance of NA specificities in the re‐treatment of antibody‐compromised patients.