Is interferon alpha in cutaneous T‐cell lymphoma a treatment of choice?

Abstract

This study was designed to evaluate the therapeutic efficacy and toxicity of recombinant interferon alpha-2a (rIFN alfa-2a) given as initial systemic therapy in untreated mycosis fungoides and/or Sezary's syndrome patients, at a slowly escalating schedule up to the maximal tolerated dose. At the same time this schedule was administered in patients who had relapsed or were refractory to previous treatment; 28 newly diagnosed and 15 previously treated patients entered the study. IFN was given daily with dose escalation from 3 to 18 MU. The last follow-up in June 1990 indicates that 90% of previously untreated patients who obtained a complete remission remain in continuous complete remission after 18 to 40 months and that 75% of previously untreated patients who obtained partial remission remain in partial remission after 20-44 months. The event-free survival projected, calculated using the Kaplan and Meier product limit technique, was 21% of all patients at 54.7 months (40% in the previously untreated groups and 14% in the previously treated group: P = 0.12). In conclusion, interferon is very effective as a single agent in cutaneous T-cell lymphomas.

Roferon-A in Combination with Tigason in Cutaneous T-Cell Lymphomas

“…Among the 25 patients with MF stages I and II, there were 20 responders (80%) after 12 months of treatment: 12 receiving interferon alfa-2a alone and 8 receiving interferon alfa-2a and etreti- 4 7 2-4x10" IU 1 1 Olsen ct al. [15] 22 Ia-IVa 3-36X 10" IU 10 3 Estrach et al [ 16] 9 Ib-IVa 5 x 10" IU 4 2 Papa et al [ 17] 45 I-IV 3-18X 10" IU 21 11 Dreno et al [18] 19 Ia-IVb 6-9x10" IU Thus, this multicentric study [18] confirms the results of three other reports [13. 19, 20] that interferon-a in combi nation with retinoid causes significant improvement in some patients with CTCL.…”

The Use of Interferons in the Treatment of Cutaneous T-Cell Lymphoma

“…The maximally tolerated dose of nonpegylated IFN alfa has been reported to be 9 to 18 million units (MU) daily, but most clinicians seem to treat patients with 3 to 6 MU thrice weekly or daily. 35,[43][44][45] It has been suggested that patients who are initially administered lower doses before being escalated to higher doses tolerate the higher doses better than individuals who are initially administered higher doses. 46 As discussed earlier, IFN alfa may also be administered intralesionally.…”

“…Papa and colleagues 45 prospectively analyzed 43 patients with stage I to IVB CTCL who received between 3 and 18 MU IFN alfa-2a (whatever dose each subject maximally tolerated) thrice weekly for 3 months, and responders were then continued on their maximally tolerated doses for 6 months. This study showed an impressive OR in 70% of patients with stage III or IV disease and in 80% of those at lesser stages.…”

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

“…Responses, which may be achieved within a few months, are observed in patients with tumor-stage MF and SS. Furthermore, interferon-alpha may be successfully combined with a number of other therapeutic modalities, including PUVA, bexarotene, chemotherapy and ECP, which are frequently utilized in the management of these patients [289][290][291][292][293][294][295][296][297][298][299][300][301][302]. For example, in a cohort of 51 patients (42 of which had advancedstage disease) treated with single-agent, low-dose, interferon-alpha, responses were observed in 34 (67%), 21 (41%) of which were complete and maintained long-term in nine patients [288].…”