title: Comparison of pegylated interferon α-2b plus psoralen PUVA versus standard interferon α-2a plus PUVA in patients with cutaneous T-cell lymphoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy profile of pegylated interferon α-2b (PEG-IFN α-2b) in combination with photochemotherapy (PUVA) in the treatment of cutaneous T-cell lymphoma (CTCL) in comparison with standard IFN α plus PUVA.
  
  
  METHODS
  Retrospective cohort study over a period of 7 years.
  
  
  METHODS
  A total of 17 consecutive CTCL patients (stage IA-IV) were retrospectively analysed for toxicity and response rates associated with PEG-IFN α-2b (1.5 μg/kg weekly) plus PUVA (n = 9) or standard IFN α-2a (9 MIU 3×/week) plus PUVA (n = 8).
  
  
  METHODS
  Differences of response rates (complete/partial remission), progression-free survival, discontinuation of therapy, safety and toxicity profiles according to World Health Organization - Common Terminology Criteria of Adverse Events (WHO-CTCAE).
  
  
  RESULTS
  Myelosuppression and liver toxicity occured more frequently during PEG-IFN α-2b plus PUVA treatment than during standard IFN α-2a plus PUVA therapy [77.8 vs. 50% (odds ratio 1.477) and 77.8 vs. 50% (odds ratio 1.692), respectively]. By contrast, the occurence of constitutional side-effects (mainly fatigue) [100 vs.77.8% (odds ratio 0.889)] and more adverse events leading to study discontinuation was considerably higher in the standard IFN α-2a plus PUVA group. The overall response rate in the PEG-IFN α-2b plus PUVA group (89%) was significantly superior.
  
  
  CONCLUSIONS
  In patients with cutaneous T-cell lymphoma PEG-IFN α-2b plus PUVA might become a promising treatment alternative as its higher rate of myelosuppression and liver toxicity is outweighed by its lower percentage of constitutional side-effects, and its significantly higher overall response. Due to the small number of participants at this retrospective study, a larger prospective study is essential to verify our results.
authors.affiliation: Department of Dermatology, University Hospital of Münster, Münster, Germany.
authors.forename: A C
authors.initials: AC
authors.lastname: Hüsken
authors.forename: A
authors.initials: A
authors.lastname: Tsianakas
authors.forename: P
authors.initials: P
authors.lastname: Hensen
authors.forename: D
authors.initials: D
authors.lastname: Nashan
authors.forename: C
authors.initials: C
authors.lastname: Loquai
authors.forename: S
authors.initials: S
authors.lastname: Beissert
authors.forename: T A
authors.initials: TA
authors.lastname: Luger
authors.forename: C
authors.initials: C
authors.lastname: Sunderkötter
authors.forename: M
authors.initials: M
authors.lastname: Schiller
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005363:Ficusin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016399:Lymphoma, T-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D017319:Photosensitizing Agents; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; D005363:Ficusin