Treatment of cutaneous T cell lymphoma with low doses of interferon alpha-2b.
OBJECTIVE: To evaluate the optimal dose and route of interferon-alpha-2b (INF-alpha-2b) given to the Chinese patients with cutaneous T-cell lymphomas (CTCL). PATIENTS AND METHODS: Sixteen Chinese patients with CTCL treated with INF-alpha-2b were evaluated. They were divided into groups according to the TNM Classification: I B (8 patients), II A (2), II B (5) and IV B (1). During induction INF-alpha-2b was given intramuscularly every other day or two times a week, beginning with a dose of 1-3 x 10(6) IU. Depending on tolerance, the dosage could be increased weekly to a maximum tolerated dose of 18 x 10(6) IU (mean, 6 x 10(6) IU/week) with administration two or three times a week. Patients with clinical response were given maintenance dosage from the start. Thereafter the dosage was gradually decreased after disappearance of skin lesions. Three patients were treated by combining intramuscular and intralesional injection of INF. RESULTS: Six patients (I B, 2 patients: II A, 2, II B, 2) achieved complete response (CR). Seven patients (I B, 5 patients) showed partial response. The overall response rate in this group was 81.25%. The prominent initial clinical response in three patients was manifested early at one week after intramuscular treatment with INF and then the skin lesions were resistant to the therapy but disappeared rapidly by combining intralesional injection of INF. The conditions of those patients obtaining CR within 3 to 6 weeks were stable for 1-36 weeks. CONCLUSIONS: This study had demonstrated that the overall response rate in treatment of patients with CTCL was 81.25% and higher (85.7%-87.5%) in the subgroups at early stages I and II of the disease. The dosage (mean dose of 6 x 10(6) IU/week) adopted by us is optimal for the Chinese patients with CTCL. Intralesional injection of INF could be recommended.
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