PUVA plus interferon α2b in the treatment of advanced or refractory to PUVA early stage mycosis fungoides: a case series.
BACKGROUND
The combination of PUVA with variable doses of systemically administered interferon α2b (IFN-α2b) reduces the number of PUVA treatments and the dose of IFN-α2b required to produce remission in all mycosis fungoides (MF) stages.


OBJECTIVE
To evaluate the efficacy of the combination of PUVA and IFN-α2b in patients with late stage or refractory to treatment early stage MF.


METHODS
The combination of PUVA three times weekly and IFN-α2b 2-5 MU three times weekly was retrospectively reviewed in 22 patients. Kaplan-Meyer method and log-rank test was used for statistical analysis.


RESULTS
Twenty-two patients were analysed, seven with refractory to PUVA early stage MF, seven with tumour stage, five with erythrodermic MF and three with Sézary syndrome (SS). The overall response rate (complete or partial response) was 68%, including 10 complete responses (CR) (45%) and five partial responses (PR) (23%). Significantly, more patients of the early stage group achieved CR compared with the advanced stage group (86% vs. 27%, P=0.03). Within the advanced stage group, CR rates were 14% vs. 37% in stage IIB and III/SS patients respectively, but the difference was not statistically significant. Patients with early stage disease had a 2-year PFS of 100% vs. 27% for the advanced stage group (P<0.001). Sustained remissions (>2 years) were achieved in five out of six complete responders in the early stage group of patients.


CONCLUSIONS
This combination of IFN-α2b and PUVA is an effective and safe treatment for refractory to treatment early stage MF patients as well as treatment-naïve advanced stage patients. Its efficacy is more pronounced in the former patient group.
Nikolaou
V
V
Department of Dermatology, University of Athens Medical School, A. Sygros Hospital, Athens, Greece. drviknik@yahoo.com
Siakantaris
M P
MP
Vassilakopoulos
T P
TP
Papadavid
E
E
Stratigos
A
A
Economidi
A
A
Marinos
L
L
Papadaki
T
T
Antoniou
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use*; D016898:Interferon-alpha; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy*; D011701:PUVA Therapy; D011994:Recombinant Proteins; D012189:Retrospective Studies; D016896:Treatment Outcome
D007370:Interferon Type I; D016898:Interferon-alpha; D011994:Recombinant Proteins; C076799:interferon-alpha 8