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Recombinant Interferon Alfa-2b in Plaque-Phase Mycosis Fungoides: Intralesional and Low-Dose Intramuscular Therapy

Recombinant Interferon Alfa-2b in Plaque-Phase Mycosis Fungoides: Intralesional and Low-Dose... Abstract • A two-part clinical trial was conducted to determine the therapeutic efficacy of recombinant interferon alfa-2b in plaque-phase mycosis fungoides. In an initial randomized double-blind study, each of six patients had two representative plaques injected intralesionally with 1 × 106 U of recombinant interferon alfa-2b per site and two control plaques injected with placebo three times weekly for four consecutive weeks. Complete clinical regression of disease was observed at ten of 12 recombinant interferon alfa-2b sites compared with one of 12 placebo-treated sites four weeks after treatment with injections was stopped. Subsequently, in an open-labeled study, five of these patients were treated intramuscularly with 5 × 106 U of recombinant interferon alfa-2b three times weekly for four weeks and two patients were treated with a second, more extended course of therapy lasting 12 to 16 weeks. Three of the five patients treated systemically showed some improvement overall, but the responses were judged not to be clinically significant. The differential response observed from intralesional and intramuscular injections may be related to differences in concentration of recombinant interferon alfa-2b achieved in lesional skin by the two methods of administration. (Arch Dermatol 1987;123:757-763) References 1. Bunn PA Jr, Foon KA, Ihde DC, et al: Recombinant leukocyte A interferon: An active agent in advanced cutaneous T-cell lymphomas . Ann Intern Med 1984;101:484-487.Crossref 2. Bunn PA Jr, Ihde DC, Foon KA: The role of recombinant interferon alfa-2a in the therapy of cutaneous T-cell lymphomas . Cancer 1986;57:1689-1695.Crossref 3. Wolff JM, Zitelli JA, Rabin BS, et al: Intralesional interferon in the treatment of early mycosis fungoides . J Am Acad Dermatol 1985;13:601-612.Crossref 4. Spiegel RJ, Spicehandler JR, Jacobs SL, et al: Low incidence of serum neutralizing factors in patients receiving recombinant alfa-2b interferon (Intron A) . Am J Med 1986;80:223-228.Crossref 5. Bunn PA Jr, Lamberg SI: Report of the committee on staging and classification of cutaneous T-cell lymphomas . Cancer Treat Rep 1979;63;725-728. 6. Steihm ER, Kronenberg LH, Rosenblatt HM, et al: Interferon: Immunobiology and clinical significance . Ann Intern Med 1982;96:80-93.Crossref 7. Foon KA, Sherwin SA, Abrams PG, et al: Treatment of advanced non-Hodgkins lymphoma with recombinant leukocyte A interferon . N Engl J Med 1984;311:1148-1152.Crossref 8. Gutterman JU, Blumenschein GR, Alexanian R, et al: Leukocyte interferon-induced tumor regression in human metastatic breast cancer, multiple myeloma, and malignant lymphoma . Ann Intern Med 1980;93:399-406.Crossref 9. Quesada JR, Gutterman JU, Hersch EM: Treatment of hairy cell leukemia with alpha interferons . Cancer 1986;57:1678-1680.Crossref 10. Ohno R, Kimura K: Treatment of multiple myeloma with recombinant interferon alfa-2a . Cancer 1986;57:1685-1688.Crossref 11. Borden EC: Interferons: Rationale for clinical trials in neoplastic disease . Ann Intern Med 1979;91:472-479.Crossref 12. Herberman RB, Oldham RK: Cell-mediated cytotoxicity against human tumors: Lessons learned and future prospects . J Biol Response Mod 1983;2:111-120. 13. Herberman RB, Thurman GB: Approaches to the immunological monitoring of cancer patients treated with natural or recombinant interferons . J Biol Response Mod 1983;2:548-562. 14. Ozer H, Gavigan M, O'Malley J, et al: Immunomodulation by recombinant interferon-alpha2 in a phase I trial in patients with lymphoproliferative malignancies . J Biol Response Mod 1983; 2:499-515. 15. Hengst JCD, Kempf RA, Kan-Mitchell J, et al: Immunological effects of recombinant interferon alpha2 in cancer patients . J Biol Response Mod 1983;2:516-527. 16. Suhadolnik RJ, Flick MB, Mosca JD, et al: 2′,5′-Oligoadeny-igoadenylate synthetase from cutaneous T-cell lymphoma: Biosynthesis, identification, quantitation, molecular size of the 2′,5′-oligoadenylates, and inhibition of protein synthesis . Biochemistry 1983; 22:4153-4158.Crossref 17. Rattner AC, Waldorf DS, Van Scott EJ: Alterations of lesions on mycosis fungoides lymphoma by direct imposition of delayed hypersensitivity reactions . Cancer 1968;21:83-88.Crossref 18. Baker BS, Swain AF, Fry L, et al: Epidermal T lymphocytes and HLA-DR expression in psoriasis . Br J Dermatol 1984;110:555-564.Crossref 19. De Panfilis G, Manara G, Ferrari C, et al: Imbalance in phenotypic expression of T cell subpopulations during different evolutional stages of lichen planus lesions . Acta Derm Venereol 1983;63:369-375. 20. Vonderheid EC, Tan E, Sobel EL, et al: Clinical implications of immunologic phenotyping in cutaneous T-cell lymphoma . J Am Acad Dermatol , in press. 21. Turbitt ML, Mackie RM: An assessment of the diagnostic value of the monoclonal antibodies Leu 8, OKT9, OKT10 and Ki67 in cutaneous lymphocytic infiltrates . Br J Dermatol 1986;115:151-158.Crossref 22. Onsrud M: Enhancement of suppressor cell generation in human mixed lymphocyte cultures by interferon . Int Arch Allergy Appl Immunol 1985;67:315-321.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Recombinant Interferon Alfa-2b in Plaque-Phase Mycosis Fungoides: Intralesional and Low-Dose Intramuscular Therapy

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1987.01660300079016
Publisher site
See Article on Publisher Site

Abstract

Abstract • A two-part clinical trial was conducted to determine the therapeutic efficacy of recombinant interferon alfa-2b in plaque-phase mycosis fungoides. In an initial randomized double-blind study, each of six patients had two representative plaques injected intralesionally with 1 × 106 U of recombinant interferon alfa-2b per site and two control plaques injected with placebo three times weekly for four consecutive weeks. Complete clinical regression of disease was observed at ten of 12 recombinant interferon alfa-2b sites compared with one of 12 placebo-treated sites four weeks after treatment with injections was stopped. Subsequently, in an open-labeled study, five of these patients were treated intramuscularly with 5 × 106 U of recombinant interferon alfa-2b three times weekly for four weeks and two patients were treated with a second, more extended course of therapy lasting 12 to 16 weeks. Three of the five patients treated systemically showed some improvement overall, but the responses were judged not to be clinically significant. The differential response observed from intralesional and intramuscular injections may be related to differences in concentration of recombinant interferon alfa-2b achieved in lesional skin by the two methods of administration. (Arch Dermatol 1987;123:757-763) References 1. Bunn PA Jr, Foon KA, Ihde DC, et al: Recombinant leukocyte A interferon: An active agent in advanced cutaneous T-cell lymphomas . Ann Intern Med 1984;101:484-487.Crossref 2. Bunn PA Jr, Ihde DC, Foon KA: The role of recombinant interferon alfa-2a in the therapy of cutaneous T-cell lymphomas . Cancer 1986;57:1689-1695.Crossref 3. Wolff JM, Zitelli JA, Rabin BS, et al: Intralesional interferon in the treatment of early mycosis fungoides . J Am Acad Dermatol 1985;13:601-612.Crossref 4. Spiegel RJ, Spicehandler JR, Jacobs SL, et al: Low incidence of serum neutralizing factors in patients receiving recombinant alfa-2b interferon (Intron A) . Am J Med 1986;80:223-228.Crossref 5. Bunn PA Jr, Lamberg SI: Report of the committee on staging and classification of cutaneous T-cell lymphomas . Cancer Treat Rep 1979;63;725-728. 6. Steihm ER, Kronenberg LH, Rosenblatt HM, et al: Interferon: Immunobiology and clinical significance . Ann Intern Med 1982;96:80-93.Crossref 7. Foon KA, Sherwin SA, Abrams PG, et al: Treatment of advanced non-Hodgkins lymphoma with recombinant leukocyte A interferon . N Engl J Med 1984;311:1148-1152.Crossref 8. Gutterman JU, Blumenschein GR, Alexanian R, et al: Leukocyte interferon-induced tumor regression in human metastatic breast cancer, multiple myeloma, and malignant lymphoma . Ann Intern Med 1980;93:399-406.Crossref 9. Quesada JR, Gutterman JU, Hersch EM: Treatment of hairy cell leukemia with alpha interferons . Cancer 1986;57:1678-1680.Crossref 10. Ohno R, Kimura K: Treatment of multiple myeloma with recombinant interferon alfa-2a . Cancer 1986;57:1685-1688.Crossref 11. Borden EC: Interferons: Rationale for clinical trials in neoplastic disease . Ann Intern Med 1979;91:472-479.Crossref 12. Herberman RB, Oldham RK: Cell-mediated cytotoxicity against human tumors: Lessons learned and future prospects . J Biol Response Mod 1983;2:111-120. 13. Herberman RB, Thurman GB: Approaches to the immunological monitoring of cancer patients treated with natural or recombinant interferons . J Biol Response Mod 1983;2:548-562. 14. Ozer H, Gavigan M, O'Malley J, et al: Immunomodulation by recombinant interferon-alpha2 in a phase I trial in patients with lymphoproliferative malignancies . J Biol Response Mod 1983; 2:499-515. 15. Hengst JCD, Kempf RA, Kan-Mitchell J, et al: Immunological effects of recombinant interferon alpha2 in cancer patients . J Biol Response Mod 1983;2:516-527. 16. Suhadolnik RJ, Flick MB, Mosca JD, et al: 2′,5′-Oligoadeny-igoadenylate synthetase from cutaneous T-cell lymphoma: Biosynthesis, identification, quantitation, molecular size of the 2′,5′-oligoadenylates, and inhibition of protein synthesis . Biochemistry 1983; 22:4153-4158.Crossref 17. Rattner AC, Waldorf DS, Van Scott EJ: Alterations of lesions on mycosis fungoides lymphoma by direct imposition of delayed hypersensitivity reactions . Cancer 1968;21:83-88.Crossref 18. Baker BS, Swain AF, Fry L, et al: Epidermal T lymphocytes and HLA-DR expression in psoriasis . Br J Dermatol 1984;110:555-564.Crossref 19. De Panfilis G, Manara G, Ferrari C, et al: Imbalance in phenotypic expression of T cell subpopulations during different evolutional stages of lichen planus lesions . Acta Derm Venereol 1983;63:369-375. 20. Vonderheid EC, Tan E, Sobel EL, et al: Clinical implications of immunologic phenotyping in cutaneous T-cell lymphoma . J Am Acad Dermatol , in press. 21. Turbitt ML, Mackie RM: An assessment of the diagnostic value of the monoclonal antibodies Leu 8, OKT9, OKT10 and Ki67 in cutaneous lymphocytic infiltrates . Br J Dermatol 1986;115:151-158.Crossref 22. Onsrud M: Enhancement of suppressor cell generation in human mixed lymphocyte cultures by interferon . Int Arch Allergy Appl Immunol 1985;67:315-321.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 1987

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