PUVA AND INTERFERON Α COMBINED THERAPY IN PATIENTS WITH MYCOSIS FUNGOIDES

Abstract

The results of mycosis fungoides (MF) treatment using therapy that combines interferon α (IFNα) and PUVA-therapy are presented. We observed 16 patients with MF. The diagnoses were verified with histological, immunohictochemical methods and molecular analysis. The response to treatment was defined by the index of the modified assessment of the severity of skin lesions scale (mSWAT). In addition, the safety and tolerability of IFNα and PUVA-therapy were evaluated. In terms of the stage of the disease, patients were distributed as follows: IB-IB - 1 (6%), IIA - 3 (19%), IIB - 6 (38%), IIIA - 2 (12.5%), IIIB - 1 (6%), IVA - 2 (12.5%), IVB - 1 (6%). PUVA-therapy was performed four times a week with the initial dose of the irradiation 0.5-1.0 J/cm2. The course of therapy consisted of 40 ± 8 procedures. The total dose was 157 ± 45 J/cm2.IFNα was prescribed to patients (3 IU three times a week). The total dose was 96 ± 31 IU. After the therapy 12 (75%) patients with stage IB-IIIA, mSWAT index was reduced by 90-100%, which corresponded to complete clinical remission in the form of the disappearance of cutaneous manifestations and subjective sensations. 3 (19%) patients with stage IIIB-IVA had mSWAT index decreasing from 50 to 75%, i.e. partial remission was observed as decrease of the injury area and rash brightness, reduce scaling, itching. 1 (6%) patient with stage IVB had no effect of the therapy. Studies have shown that PUVA-therapy in combination with interferon α can be successfully used at patients with MF, regardless of the disease stages, however, more positive effect was in patients with stage IB-IIB MF.