Photochemotherapy alone or combined with interferon alpha-2a in the treatment of cutaneous T-cell lymphoma

J Invest Dermatol. 1990 Dec;95(6 Suppl):198S-205S. doi: 10.1111/1523-1747.ep12875523.

Abstract

Eighty-two patients with either mycosis fungoides (MF) or parapsoriasis en plaques were treated with psoralens ultraviolet A light (PUVA). Clinical and histologic parameters were followed for a period from 6 months to 10 years. Complete clinical clearing of lesions was observed in 51 patients (62%) and most of them were in limited-plaque MF group or parapsoriasis en plaque. The mean total dose of PUVA for complete clearing was less for early MF. Thirty-one patients (38%) relapsed and responded to additional PUVA. Patients in early stages of the disease remained clear for up to 68 months after the first course of PUVA. Post-treatment skin biopsies with early MF showed histologic clearing. A new combination therapy for MF is presented in 15 patients. Recombinant interferon alpha-2a (Roferon-A), administered intramuscularly combined with PUVA were tested in a phase I trial. Interferon doses were from 6-30 million units three times weekly. Disease stages ranged from I-B to IV-B. Complete responses were obtained in 12 of 15 patients, and partial responses seen in 2 of 15 patients, for an overall response rate of 93%. The median duration of response exceeded 23 months (range, 3 to 25 months). All responding patients have been maintained on therapy. The dose-limiting toxicities were constitutional symptoms such as fevers and malaise (93.3%), leukopenias (40.0%), mental status changes consisting of depression and confusion (33.3%), and photosensitivity (26.6%). Interferon plus PUVA appear to be highly effective regimens for the treatment of patients with cutaneous T-cell lymphomas.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Drug Evaluation
  • Female
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / adverse effects
  • Interferon-alpha / therapeutic use*
  • Lymphoma, T-Cell, Cutaneous / drug therapy*
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Male
  • Middle Aged
  • Mycosis Fungoides / drug therapy
  • Neoplasm Staging
  • PUVA Therapy*
  • Recombinant Proteins
  • Sezary Syndrome / drug therapy
  • Skin Neoplasms / drug therapy*

Substances

  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins