Therapeutic use of interferon‐α for lymphomatoid papulosis

BACKGROUND Lymphomatoid papulosis is a primary cutaneous, CD30 positive lymphoproliferative disorder with the potential to transform into systemic, malignant lymphoma. Therapeutic strategies for patients with lymphomatoid papulosis have been designed to prevent transformation but have proved to be either inefficacious or limited by side effects. METHODS The authors compared the clinical, histologic, and immunohistochemical features from a group of five patients receiving interferon‐α (IFN‐α) subcutaneously three times per week with the same features from a group of six patients receiving conventional therapy, including photochemotherapy, antibiotics, topical corticosteroids, or surgery, in an open trial. RESULTS In the IFN‐α group, four patients showed a complete remission, and one patient showed a partial remission within a time period of 6 weeks. Two patients developed disease recurrences after discontinuation of short term IFN‐α therapy (5–7 months). Thereof, one patient went into stable remission after long term IFN‐α therapy (17 months), and one patient remains in partial remission. In the control group, one patient went into spontaneous remission, two patients showed partial remission, of which one patient developed progressive disease at a later time point, whereas three patients have recurrent disease despite of treatment. CONCLUSIONS The current results indicate that the treatment with IFN‐α of patients with lymphomatoid papulosis alters the clinical course of the disease with fewer side effects than previous regimens; however, short term treatment does not induce stable remission. Therefore, prolonged treatment appears to be warranted for these patients. Cancer 2000;89:1603–10. © 2000 American Cancer Society. The results of this study indicate that interferon‐α is a promising therapeutic modality for patients with lymphomatoid papulosis (primary cutaneous, CD30 positive lymphoproliferative disorder) compared with traditional strategies with either low response rates or limiting side effects.