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 studi es 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 evalu ate 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. I n 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 combi nation 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 c onsiderably 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 re mission (CR) and 15/25 (56%) achieved partial remission (PR). One to five m onths 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 F FTF was 82% at 12 months and 62% at 24 months. Disease free survival projec ted 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 l ong-lasting, in patients with early MF. (C) 1999, Ferrata Storti Foundation .