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• W4233676327 abstract "To the editor:Fimiani et al1Fimiani M Rubegni P De Aloe G Andreassi L Role of extracorporeal photochemotherapy alone and in combination with interferon alfa in the treatment of cutaneous T-cell lymphoma.J Am Acad Dermatol. 1999; 41: 502-503Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar reported on 8 patients with stage IB cutaneous T-cell lymphoma (CTCL) treated with extracorporeal photopheresis (ECP) as a single agent (J Am Acad Dermatol 1999;41:502–3). A complete response (CR) was obtained in 2 patients and a partial response (PR) was seen in 5. Two patients stabilized and interferon alfa (IFN-α) was added to the ECP regimen. One patient experienced CR and the second had a minor response. The authors state that the results suggest a synergistic effect for the combination therapy.A literature search revealed 6 additional reports of combination ECP and IFN-α therapy for CTCL. Rook et al2Rook AH Prystowsky MB Cassin M Boufal M Lessin S Combined therapy for Sezary syndrome with extracorporeal photochemotherapy and low-dose interferon alfa therapy.Arch Dermatol. 1991; 127: 1535-1540Crossref PubMed Scopus (83) Google Scholar described a man who had rapidly advancing Sézary syndrome while receiving ECP as a single agent. Marked improvement occurred after adding IFN-α to the ECP. IFN-α was not used as a single agent. The authors suggest that combined ECP and IFN-α may have additive efficacy in the treatment of Sézary syndrome. Cohen et al3Cohen JH Lessin SR Vowels BR Benoit B Witmer WK Rook AH The sign of Leser-Trelat in association with Sezary syndrome: simultaneous disappearance of seborrheic keratoses and malignant T-cell clone during combined therapy with photopheresis and interferon alfa.Arch Dermatol. 1993; 129: 1213-1215Crossref PubMed Scopus (24) Google Scholar reported the case of a man with Sézary syndrome who had a minimal response to ECP, but experienced marked improvement when IFN-α was added to the ECP. IFN-α was not used as a single agent.Vonderheid et al4Vonderheid EC Bigler RD Greenberg AS Neukum SJ Micaily B Extracorporeal photopheresis and recombinant interferon alfa 2b in Sezary syndrome: use of dual marker labeling to monitor therapeutic response.Am J Clin Oncol. 1994; 17: 255-263Crossref PubMed Scopus (46) Google Scholar treated 6 patients with advanced Sézary syndrome with combination ECP and low-dose IFN-α therapy. Minimal improvement was obtained in 4 patients; however, significant improvement occurred in one patient after the IFN-α dose was increased. None of the patients received either ECP or IFN-α as a single agent. The authors conclude that the combination of ECP and low-dose IFN-α was not effective in their series of patients with advanced Sézary syndrome.Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar summarized the results of Olsen's unpublished prospective study in which 20 patients with CTCL, stages IA-IVB, were treated either with IFN-α alone or with combined IFN-α and ECP. Of the 11 patients treated with IFN-α alone, one experienced CR and 3 had a PR. Of the 9 patients treated with combination IFN-α and ECP, none had a CR and 2 had a PR. Thus results with IFN-α alone appeared to be better than those obtained with the combination; however, the lack of patient details makes evaluation difficult.Gottlieb et al6Gottlieb SL Wolfe JT Fox FE DeNardo BJ Macey WH Bromley PG et al.Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: a 10-year experience at a single institution.J Am Acad Dermatol. 1996; 35: 946-957Abstract Full Text PDF PubMed Scopus (183) Google Scholar reported a retrospective study in which 28 patients with CTCL, the majority of whom had stage III or IV disease with circulating Sézary cells, were initially treated with ECP alone. Later, IFN-α and, in some cases, other agents were added to the ECP in 9 patients. Of the 9 patients, 5 had an enhanced response to the combination therapy compared with ECP alone. None received IFN-α as a monotherapy.Dippel et al7Dippel E Schrag H Goerdt S Orfanos CE Extracorporeal photopheresis and interferon-α in advanced cutaneous T-cell lymphoma.Lancet. 1997; 350: 32-33Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar described 19 patients with wide-spread advanced CTCL. Ten received ECP alone, and 9 received combination ECP with IFN-α. Results with the combination therapy were superior to those obtained from ECP alone. None of the patients received IFN-α as monotherapy.In summary, of the 7 reports of combination ECP and IFN-α therapy for CTCL, only the report of Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar compared results with IFN-α alone versus those with the combination, and that study suggested a better response to IFN-α alone. Regardless, because none of the other studies included an IFN-α-only arm, there is to date no evidence supporting the hypothesis of a synergistic or additive benefit of combination ECP with IFN-α therapy versus IFN-α alone. It is obvious that prospective randomized trials are needed to clarify this issue. The efficacy of IFN-α monotherapy for CTCL is well documented.8Jumbou O Guyen JMN Tessier MH Legoux B Dreno B Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa.Br J Dermatol. 1999; 140: 427-431Crossref PubMed Scopus (90) Google Scholar To the editor:Fimiani et al1Fimiani M Rubegni P De Aloe G Andreassi L Role of extracorporeal photochemotherapy alone and in combination with interferon alfa in the treatment of cutaneous T-cell lymphoma.J Am Acad Dermatol. 1999; 41: 502-503Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar reported on 8 patients with stage IB cutaneous T-cell lymphoma (CTCL) treated with extracorporeal photopheresis (ECP) as a single agent (J Am Acad Dermatol 1999;41:502–3). A complete response (CR) was obtained in 2 patients and a partial response (PR) was seen in 5. Two patients stabilized and interferon alfa (IFN-α) was added to the ECP regimen. One patient experienced CR and the second had a minor response. The authors state that the results suggest a synergistic effect for the combination therapy.A literature search revealed 6 additional reports of combination ECP and IFN-α therapy for CTCL. Rook et al2Rook AH Prystowsky MB Cassin M Boufal M Lessin S Combined therapy for Sezary syndrome with extracorporeal photochemotherapy and low-dose interferon alfa therapy.Arch Dermatol. 1991; 127: 1535-1540Crossref PubMed Scopus (83) Google Scholar described a man who had rapidly advancing Sézary syndrome while receiving ECP as a single agent. Marked improvement occurred after adding IFN-α to the ECP. IFN-α was not used as a single agent. The authors suggest that combined ECP and IFN-α may have additive efficacy in the treatment of Sézary syndrome. Cohen et al3Cohen JH Lessin SR Vowels BR Benoit B Witmer WK Rook AH The sign of Leser-Trelat in association with Sezary syndrome: simultaneous disappearance of seborrheic keratoses and malignant T-cell clone during combined therapy with photopheresis and interferon alfa.Arch Dermatol. 1993; 129: 1213-1215Crossref PubMed Scopus (24) Google Scholar reported the case of a man with Sézary syndrome who had a minimal response to ECP, but experienced marked improvement when IFN-α was added to the ECP. IFN-α was not used as a single agent.Vonderheid et al4Vonderheid EC Bigler RD Greenberg AS Neukum SJ Micaily B Extracorporeal photopheresis and recombinant interferon alfa 2b in Sezary syndrome: use of dual marker labeling to monitor therapeutic response.Am J Clin Oncol. 1994; 17: 255-263Crossref PubMed Scopus (46) Google Scholar treated 6 patients with advanced Sézary syndrome with combination ECP and low-dose IFN-α therapy. Minimal improvement was obtained in 4 patients; however, significant improvement occurred in one patient after the IFN-α dose was increased. None of the patients received either ECP or IFN-α as a single agent. The authors conclude that the combination of ECP and low-dose IFN-α was not effective in their series of patients with advanced Sézary syndrome.Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar summarized the results of Olsen's unpublished prospective study in which 20 patients with CTCL, stages IA-IVB, were treated either with IFN-α alone or with combined IFN-α and ECP. Of the 11 patients treated with IFN-α alone, one experienced CR and 3 had a PR. Of the 9 patients treated with combination IFN-α and ECP, none had a CR and 2 had a PR. Thus results with IFN-α alone appeared to be better than those obtained with the combination; however, the lack of patient details makes evaluation difficult.Gottlieb et al6Gottlieb SL Wolfe JT Fox FE DeNardo BJ Macey WH Bromley PG et al.Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: a 10-year experience at a single institution.J Am Acad Dermatol. 1996; 35: 946-957Abstract Full Text PDF PubMed Scopus (183) Google Scholar reported a retrospective study in which 28 patients with CTCL, the majority of whom had stage III or IV disease with circulating Sézary cells, were initially treated with ECP alone. Later, IFN-α and, in some cases, other agents were added to the ECP in 9 patients. Of the 9 patients, 5 had an enhanced response to the combination therapy compared with ECP alone. None received IFN-α as a monotherapy.Dippel et al7Dippel E Schrag H Goerdt S Orfanos CE Extracorporeal photopheresis and interferon-α in advanced cutaneous T-cell lymphoma.Lancet. 1997; 350: 32-33Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar described 19 patients with wide-spread advanced CTCL. Ten received ECP alone, and 9 received combination ECP with IFN-α. Results with the combination therapy were superior to those obtained from ECP alone. None of the patients received IFN-α as monotherapy.In summary, of the 7 reports of combination ECP and IFN-α therapy for CTCL, only the report of Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar compared results with IFN-α alone versus those with the combination, and that study suggested a better response to IFN-α alone. Regardless, because none of the other studies included an IFN-α-only arm, there is to date no evidence supporting the hypothesis of a synergistic or additive benefit of combination ECP with IFN-α therapy versus IFN-α alone. It is obvious that prospective randomized trials are needed to clarify this issue. The efficacy of IFN-α monotherapy for CTCL is well documented.8Jumbou O Guyen JMN Tessier MH Legoux B Dreno B Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa.Br J Dermatol. 1999; 140: 427-431Crossref PubMed Scopus (90) Google Scholar Fimiani et al1Fimiani M Rubegni P De Aloe G Andreassi L Role of extracorporeal photochemotherapy alone and in combination with interferon alfa in the treatment of cutaneous T-cell lymphoma.J Am Acad Dermatol. 1999; 41: 502-503Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar reported on 8 patients with stage IB cutaneous T-cell lymphoma (CTCL) treated with extracorporeal photopheresis (ECP) as a single agent (J Am Acad Dermatol 1999;41:502–3). A complete response (CR) was obtained in 2 patients and a partial response (PR) was seen in 5. Two patients stabilized and interferon alfa (IFN-α) was added to the ECP regimen. One patient experienced CR and the second had a minor response. The authors state that the results suggest a synergistic effect for the combination therapy. A literature search revealed 6 additional reports of combination ECP and IFN-α therapy for CTCL. Rook et al2Rook AH Prystowsky MB Cassin M Boufal M Lessin S Combined therapy for Sezary syndrome with extracorporeal photochemotherapy and low-dose interferon alfa therapy.Arch Dermatol. 1991; 127: 1535-1540Crossref PubMed Scopus (83) Google Scholar described a man who had rapidly advancing Sézary syndrome while receiving ECP as a single agent. Marked improvement occurred after adding IFN-α to the ECP. IFN-α was not used as a single agent. The authors suggest that combined ECP and IFN-α may have additive efficacy in the treatment of Sézary syndrome. Cohen et al3Cohen JH Lessin SR Vowels BR Benoit B Witmer WK Rook AH The sign of Leser-Trelat in association with Sezary syndrome: simultaneous disappearance of seborrheic keratoses and malignant T-cell clone during combined therapy with photopheresis and interferon alfa.Arch Dermatol. 1993; 129: 1213-1215Crossref PubMed Scopus (24) Google Scholar reported the case of a man with Sézary syndrome who had a minimal response to ECP, but experienced marked improvement when IFN-α was added to the ECP. IFN-α was not used as a single agent. Vonderheid et al4Vonderheid EC Bigler RD Greenberg AS Neukum SJ Micaily B Extracorporeal photopheresis and recombinant interferon alfa 2b in Sezary syndrome: use of dual marker labeling to monitor therapeutic response.Am J Clin Oncol. 1994; 17: 255-263Crossref PubMed Scopus (46) Google Scholar treated 6 patients with advanced Sézary syndrome with combination ECP and low-dose IFN-α therapy. Minimal improvement was obtained in 4 patients; however, significant improvement occurred in one patient after the IFN-α dose was increased. None of the patients received either ECP or IFN-α as a single agent. The authors conclude that the combination of ECP and low-dose IFN-α was not effective in their series of patients with advanced Sézary syndrome. Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar summarized the results of Olsen's unpublished prospective study in which 20 patients with CTCL, stages IA-IVB, were treated either with IFN-α alone or with combined IFN-α and ECP. Of the 11 patients treated with IFN-α alone, one experienced CR and 3 had a PR. Of the 9 patients treated with combination IFN-α and ECP, none had a CR and 2 had a PR. Thus results with IFN-α alone appeared to be better than those obtained with the combination; however, the lack of patient details makes evaluation difficult. Gottlieb et al6Gottlieb SL Wolfe JT Fox FE DeNardo BJ Macey WH Bromley PG et al.Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: a 10-year experience at a single institution.J Am Acad Dermatol. 1996; 35: 946-957Abstract Full Text PDF PubMed Scopus (183) Google Scholar reported a retrospective study in which 28 patients with CTCL, the majority of whom had stage III or IV disease with circulating Sézary cells, were initially treated with ECP alone. Later, IFN-α and, in some cases, other agents were added to the ECP in 9 patients. Of the 9 patients, 5 had an enhanced response to the combination therapy compared with ECP alone. None received IFN-α as a monotherapy. Dippel et al7Dippel E Schrag H Goerdt S Orfanos CE Extracorporeal photopheresis and interferon-α in advanced cutaneous T-cell lymphoma.Lancet. 1997; 350: 32-33Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar described 19 patients with wide-spread advanced CTCL. Ten received ECP alone, and 9 received combination ECP with IFN-α. Results with the combination therapy were superior to those obtained from ECP alone. None of the patients received IFN-α as monotherapy. In summary, of the 7 reports of combination ECP and IFN-α therapy for CTCL, only the report of Olsen and Bunn5Olsen EA Bunn PA Interferon in the treatment of cutaneous T-cell lymphoma.Hematol/Oncol Clin North Am. 1995; 9: 1089-1107PubMed Google Scholar compared results with IFN-α alone versus those with the combination, and that study suggested a better response to IFN-α alone. Regardless, because none of the other studies included an IFN-α-only arm, there is to date no evidence supporting the hypothesis of a synergistic or additive benefit of combination ECP with IFN-α therapy versus IFN-α alone. It is obvious that prospective randomized trials are needed to clarify this issue. The efficacy of IFN-α monotherapy for CTCL is well documented.8Jumbou O Guyen JMN Tessier MH Legoux B Dreno B Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa.Br J Dermatol. 1999; 140: 427-431Crossref PubMed Scopus (90) Google Scholar" @default.
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• W4233676327 title "Evidence is lacking for a synergistic or additive effect of combination extracorporeal photopheresis with interferon alfa for cutaneous T-cell lymphoma" @default.
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