目的:干扰素(IFN)-a通常与补骨脂素加紫外线A(PUVA)联合用于早期或晚期皮肤靶向治疗难以治疗的真菌病(MF)患者。主要目的是评估PUVA和低剂量IFN-α-2a联合治疗在早期和晚期MF患者中的有效性。
方法:对68例接受每周两次或三次PUVA和每周三次INF-a3MU联合治疗至少3个月的患者进行回顾性分析。治疗反应被评估为完全缓解(CR),部分缓解,疾病稳定,或进展。
结果:开始时,大多数患者(66.2%)患有早期疾病.在27.9%的病例中,这是MF诊断后的初始治疗.联合治疗的中位持续时间为11个月。45.6%的患者完全缓解,总缓解率为60.3%。平均反应持续时间为5个月。早期患者的完全缓解率在统计学上显着升高(p<0.05)。CR与性别之间无统计学意义的相关性,组织病理学特征,或实验室参数。在CR患者中,80%经历了复发,在早期患者中明显更高(p<0.05)。然而,早期和晚期之间的无病生存率没有显着差异(p>.05)。
结论:研究结果表明,PUVA+低剂量INF-a联合治疗早期比晚期更有效。此外,获得CR的患者停止治疗后复发率较高.
OBJECTIVE: Interferon (IFN)-a is often used in combination with psoralen plus ultraviolet A (PUVA) in patients with mycosis fungoides (MF) refractory to skin-targeted therapies in early or advanced stages. The main objective is to evaluate the effectiveness of combined PUVA and low-dose IFN-α-2a therapy in patients with early- and advanced-stage MF.
METHODS: Sixty-eight patients who received a combination of PUVA twice or thrice a week and INF-a 3 MU thrice a week for at least 3 months were reviewed retrospectively. The treatment response was evaluated as complete remission (CR), partial remission, stable disease, or progression.
RESULTS: At the initiation, the majority of patients (66.2%) had early-stage disease. In 27.9% of cases, this was the initial treatment administered following the diagnosis of MF. The median duration of combination therapy was 11 months. Complete remission was achieved in 45.6% of the patients with an overall response rate of 60.3%. The mean duration of response was 5 months. Complete remission was statistically significantly higher in early-stage patients (p < .05). No statistically significant correlation was observed between CR and gender, histopathological features, or laboratory parameters. In patients with CR, 80% experienced relapse, significantly higher in early-stage patients (p < .05). However, there was no significant difference in disease-free survival between early and advanced stages (p > .05).
CONCLUSIONS: The study results indicated that PUVA + low-dose INF-a combination therapy was more effective in the early stage than in the advanced stage. Additionally, there was a high relapse rate after the cessation of treatment in patients who achieved CR.