Successful treatment of severe respiratory papillomatosis with intravenous cidofovir and interferon alpha-2b.
In contrast to uncomplicated juvenile laryngeal papillomas which may regress spontaneously, papillomatosis involving pulmonary parenchyma is associated with a poor outcome. This report represents the case of a 34 yr-old female in whom respiratory papillomatosis resulted in voice problems and recurrent pneumonias due to bronchial obstruction. A computed tomographic scan of the chest showed worsening bilateral round cavitating consolidations. Bronchoscopy revealed polypoid lesions of the right vocal cord and the midtrachea which were confirmed as squamous papillomatosis by histology. Interferon (IFN)alpha-2b treatment was inefficient as was cidofovir monotherapy on a maintenance basis. Six months of IFN-alpha-2b and cidofovir in combination led to a complete macroscopic disappearance of the laryngeal lesions and to an impressive regression of the tracheal papillomas and of the intrapulmonary consolidations. These data provide support that severe respiratory papillomatosis can be safely treated by interferon alpha-2b and cidofovir in combination. Probably the same mechanisms as in ribavirin plus interferon alpha-2b, in the treatment of patients with chronic hepatitis C, are responsible for the therapeutic success in this case.
Armbruster
C
C
Second Medical Dept/Pumologisches Zentrum.
Kreuzer
A
A
Vorbach
H
H
Huber
M
M
Armbruster
C
C
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D007822:Laryngeal Neoplasms / Q000188:drug therapy; D008175:Lung Neoplasms / Q000188:drug therapy*; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage*; D010212:Papilloma / Q000188:drug therapy*; D011994:Recombinant Proteins; D014134:Tracheal Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D011994:Recombinant Proteins; D003596:Cytosine; D000077404:Cidofovir