Prognosis in early stage cutaneous T-cell lymphoma treated with psoralen plus ultraviolet A irradiation and low-dose interferon-α: Long-term efficacy and survival according to conventional and emerging clinical endpoints

Dermatol Ther. 2022 Oct;35(10):e15737. doi: 10.1111/dth.15737. Epub 2022 Aug 9.

Abstract

Patients with early stage cutaneous T cell lymphoma (CTCL) usually have a benign and chronic disease course, characterized by temporally response to conventional skin directed therapies and intrinsic possibility to evolve. Using the combination of psoralen plus ultraviolet A irradiation (PUVA) and low-dose interferon-α (INF), the principal treatment goal is to keep confined the disease to the skin, preventing disease progression. Among 87 patients with early stage IA to IIA MF treated with low-dose IFN-α2b and PUVA in our center, complete remission (CR) were reported in 70 patients (80.5%) and the overall response rate (ORR) was 97.8% (n = 85), with a median time to best response to therapy of 5 months (range, 1-30). Among the responders, only the 8% of patients had a relapse with major event. The median follow-up was 207 months (range, 6-295). Survival data showed a median overall survival (OS) not reached (95% CI; 235-NR months), a disease free survival (DFS) of 210 months (95% CI; 200-226 months) and a median time to next treatment (TTNT) of 38.5 months (95% CI, 33-46 months). The long follow up of this study verifies our preliminary results already published in 2006 and confirms the efficacy of INF-PUVA combination therapy in a real world setting, according conventional (OS and DFS) and emerging (TTNT) clinical endpoint of treatment efficacy.

Keywords: cutaneous T-cell lymphoma; interferon-α; mycosis fungoides; psoralen plus ultraviolet A irradiation.

MeSH terms

  • Ficusin / therapeutic use
  • Humans
  • Interferon-alpha / therapeutic use
  • Lymphoma, T-Cell, Cutaneous* / pathology
  • Mycosis Fungoides* / drug therapy
  • Mycosis Fungoides* / pathology
  • Mycosis Fungoides* / radiotherapy
  • Neoplasm Recurrence, Local / drug therapy
  • PUVA Therapy / methods
  • Prognosis
  • Skin Neoplasms* / pathology
  • Treatment Outcome

Substances

  • Interferon-alpha
  • Ficusin