USE OF INTERFERON-ALPHA IN LARYNGEAL PAPILLOMATOSIS - 8 YEARS OF THE CUBAN NATIONAL PROGRAM

Laryngeal papillomatosis is one of the first diseases where interferon (IFN) was found to be effective. In 1983, a programme for the treatme nt of all such cases started in Cuba. Up to December 1991, 125 patient s (92 children, 33 adults) have been treated: 102 with leucocyte IFN-a lpha, 12 with recombinant IFN-alpha-2b, and 11 have received both prep arations. Case management consisted of surgical removal of the lesions followed by an IFN schedule starting with 10(5) IU/kg of weight in ch ildren or 6 x 10(6) IU in adults, i.m. daily. The dose was progressive ly reduced, as long as no relapses occurred. At the end of the one-yea r schedule the doses were reduced to 5 x 10(4) IU/kg in children or 3 x 10(6) IU in adults, weekly. If there was a relapse, it was removed s urgically and the patient returned to a higher dose level. Most cases (89; 71 per cent) have not relapsed after the treatment; 60 of them ha ve been followed for more than three years. In those with relapses, th e frequency of recurrence decreased in all but four patients. The trea tment seemed to be more effective if initiated less than three months after the disease onset. The tracheostomy could be removed in five out of seven patients who needed it before the IFN treatment and was nece ssary in only three new cases during IFN treatment. In two of these, d ecannulation was possible later on. In a total of 14 patients relapses persisted after several cycles of IFN treatment. They were considered resistant to such treatment. No severe side effects were reported. Th e most frequent ones were fever, drowsiness, increased bronchial secre tion, chills and headache. The establishment of this programme has mai ntained the disease under control in Cuba.