Therapeutic use of interferon-alpha for lymphomatoid papulosis

BACKGROUND. Lymphomatoid papulosis is a primary cutaneous, CD30 positive ly mphoproliferative disorder with the potential to transform into systemic, m alignant lymphoma. Therapeutic strategies for patients with lymphomatoid pa pulosis have been designed to prevent transformation but have proved to be either inefficacious or limited by side effects. METHODS. The authors compared the clinical, histologic, and immunohistochem ical features from a group of five patients receiving interferon-alpha (IFN -alpha) subcutaneously three times per week with the same features from a g roup of six patients receiving conventional therapy, including photochemoth erapy, antibiotics, topical corticosteroids, or surgery, in an open trial. RESULTS. In the IFN-alpha group, four patients showed a complete remission, and one patient showed a partial remission within a time period of 6 weeks . Two patients developed disease recurrences after discontinuation of short term IFN-alpha therapy (5-7 months). Thereof, one patient went into stable remission after long term IFN-alpha therapy (17 months), and one patient r emains in partial remission. In the control group, one patient went into sp ontaneous remission, two patients showed partial remission, of which one pa tient developed progressive disease at a later time point, whereas three pa tients have recurrent disease despite of treatment. CONCLUSIONS. The current results indicate that the treatment with IFN-alpha of patients with lymphomatoid papulosis alters the clinical course of the disease with fewer side effects than previous regimens; however, short term treatment does not induce stable remission. Therefore, prolonged treatment appears to be warranted for these patients. Cancer 2000;89:1603-10. (C) 20 00 American Cancer Society.