title: Interferon and low dose methotrexate improve outcome in refractory mycosis fungoides/Sézary syndrome.
abstract: Treatment of refractory mycosis fungoides and Sézary syndrome remain unsatisfactory. In this study, we assessed the efficacy and toxicity of low-dose methotrexate (10 mg/m(2), biweekly) and interferon (9.0 MU, three times a week) as induction therapy by 6 or 12 months, followed, if patients achieved a complete remission, by interferon maintenance until toxicity or relapse. In an intent-to-treat analysis, 158 patients were considered evaluable. Complete response (biopsy proven) was observed in 112 patients (49 [31%] at 6 months and 63 [49%] at 12 months); thus, the complete response rate was 74%. With a median follow-up of 155 months (range, 62-181), progression-free disease was 71% and overall survival was 69%. Acute toxicity was mild, treatment was well tolerated, and to date no late toxicity has been observed. We conclude that this regimen is a benefit to this setting of patients, with excellent outcome and mild toxicity.
authors.affiliation: Oncology Research Unit, Nacional Medical Center, IMSS, México, D.F. Mexico. augustin.aviles@imss.gob.mx
authors.forename: Agustin
authors.initials: A
authors.lastname: Avilés
authors.forename: M Jesús
authors.initials: MJ
authors.lastname: Nambo
authors.forename: Natividad
authors.initials: N
authors.lastname: Neri
authors.forename: Claudia
authors.initials: C
authors.lastname: Castañeda
authors.forename: Sergio
authors.initials: S
authors.lastname: Cleto
authors.forename: Martha
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Judith
authors.initials: J
authors.lastname: Huerta-Guzmán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy* / Q000473:pathology; D011994:Recombinant Proteins; D012008:Recurrence; D012751:Sezary Syndrome / Q000188:drug therapy* / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D008727:Methotrexate