TREATMENT OF ADULT T-CELL LEUKEMIA-LYMPHOMA WITH A COMBINATION OF INTERFERON-ALFA AND ZIDOVUDINE

Background. Infection with the human T-cell lymphotropic virus type I, a retrovirus, can cause a distinctive cancer, adult T-cell leukemia-l ymphoma. The median survival of patients with the acute and lymphomato us forms of the disease is short, despite the use of cytotoxic chemoth erapy. Methods: We treated 19 patients with acute or lymphomatous form s of adult T-cell leukemia-lymphoma with oral zidovudine (200 mg five times dairy) and interferon alfa (Intron A, 5 million to 10 million un its subcutaneously each day). Seven of these patients had either relap sed after multiagent cytotoxic chemotherapy or failed to respond to th at treatment. Results. Major responses were achieved in 58 percent of the patients (11 of 19), including complete remission in 26 percent (5 of 19). Four patients in whom prior cytotoxic therapy had failed had major responses, two of which were complete remissions. Six patients h ave survived for more than 12 months, with the longest remission since the discontinuation of treatment lasting more than 59 months. Conclus ions. The combination of zidovudine and interferon alfa has activity a gainst adult T-cell leukemia-lymphoma, even in patients in whom prior cytotoxic therapy has failed. This regimen should be evaluated further for its role in the treatment of adult T-cell leukemia-lymphoma.