Durable loss of a malignant T-cell clone in a stage IV cutaneous T-cell lymphoma patient treated with high-dose interferon and photopheresis

Stage IV cutaneous T-cell lymphoma (CTCL) has a notoriously poor prognosis and many treatment options stage IV CTCL with combination photopheresis and exist. We describe the successful treatment of a case of stage high-dose i nterferon alfa (IFN alpha). The patient was treated with combination therap y of monthly photopheresis and daily doses of IFN alpha up to 36 MU. Respon se to therapy was followed by clinical observation and Southern blot analys is for the detection of a malignant clone. The findings of this case were c ompared with others using a computer-based literature review A complete cli nical response lasting 64 months was achieved. Clinical relapse was precede d by an increase in the CD4/CD8 ratio and by reappearance of the T-cell rec eptor gene rearrangement. Combined photopheresis and high-dose IFN alpha le d to a durable and sustained complete response in stage IV CTCL. CD4/CD8 ra tios and T-cell gene rearrangements may be helpful in patient management.