Low Dose Interferon-Alpha 2b Combined With Puva Is An Effective Treatment Of Early Stage Mycosis Fungoides: Results Of A Multicenter Study

Background and Objective. The early stages of mycosis fungoides (MF) can be treated but not cured by photochemotherapy (PUVA) alone; some recent studies of the effect of a combination of human interferon-alpha (IFN alpha) and PUVA reported a high degree of response. The aim of our study was to evaluate the activity of a low dose of IFN-alpha 2b combined with PUVA.Design and Methods. Twenty-five patients were included: 16 men and 9 women aged between 23-80 years; 19 patients had stage I and 6 stage II disease. In the induction phase, the dose of IFN alpha was gradually raised over 6-8 weeks to the target dose of 18 MU/week; in the maintenance phase, the combination with PUVA allowed IFN alpha to be reduced to a maximum dose of 6 MU/week; in this way the cumulative administration of IFN alpha and PUVA was considerably lower than in similar combination protocols. Treatment success was analyzed in terms of freedom from treatment failure (FFTF).Results. After the induction phase 9/25 patients (36%) achieved complete remission (CR) and 15/25 (56%) achieved partial remission (PR). One to five months from the beginning of the maintenance phase, a CR was recorded in 19/25 patients (76%) and a PR in 5/25 patients (20%) accounting for an overall response rate of 96%. The median of FFTF was not reached; probability of FFTF was 82% at 12 months and 62% at 24 months. Disease free survival projected to 48 months was 75%.Interpretation and Conclusions. Even with low doses of IFN alpha plus PUVA it is possible to achieve excellent clinical responses, many of which are long-lasting, in patients with early MF. (C) 1999, Ferrata Storti Foundation.