Use of interferon-alpha in recurrent respiratory papillomatosis: 20-year follow-up.
OBJECTIVE
The aim of this study was analysis of the results of use of interferon-alpha (IFN-alpha) in patients with recurrent respiratory papillomatosis (RRP) and correlation of the results with human papillomavirus (HPV) type.


METHODS
A multicenter prospective series (42 patients from 22 hospitals) yielded 20 years of follow-up of patients with RRP and HPV typing who were treated with IFN-alpha in doses of 3 MU/m2 3 times per week.


RESULTS
During long-term follow-up (mean +/- SD, 172 +/- 36.8 months), the rate of event-free survival evaluated by Kaplan-Meier analysis was 42.8%, and the overall survival rate was 82.6%. The HPV typing revealed an association of HPV 11 with a more aggressive disease course (64% of HPV 11 patients versus 24% of HPV 6 patients), a lower incidence of long-term response to IFN-alpha therapy (14% of HPV 11 patients versus 64% of HPV 6 patients), and a higher incidence of malignant transformation and mortality during follow-up (36% and 24%, respectively, of HPV 11 patients versus 0% of HPV 6 patients).


CONCLUSIONS
The obtained results revealed maximal effectiveness of IFN-alpha therapy in RRP patients with HPV 6 as compared with HPV 11. The association of HPV 11 with a worse long-term response to IFN-alpha therapy and a higher incidence of malignant transformation and mortality is clinically important and indicates the necessity of HPV typing in RRP patients after the first biopsy.
Gerein
Valentin
V
Department of Pediatric Pathology, Institute of Pathology, Johannes Gutenberg University of Mainz, Germany.
Rastorguev
Eugen
E
Gerein
Johann
J
Jecker
Peter
P
Pfister
Herbert
H
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015344:DNA Probes, HPV / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D016898:Interferon-alpha / Q000627:therapeutic use*; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010212:Papilloma / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D027383:Papillomaviridae / Q000145:classification; D011446:Prospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D015344:DNA Probes, HPV; D016898:Interferon-alpha