Combined Therapy for Sézary Syndrome with Extracorporeal Photochemotherapy and Low-Dose Interferon Alfa Therapy: Clinical, Molecular, and Immunologic Observations

Alain H. Rook, Michael B. Prystowsky, Maureen Cassin, Margaret Boufal, Stuart R. Lessin

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Extracorporeal photochemotherapy is a well-tolerated treatment of palliative benefit for patients with the Sézary syndrome, but up to 25% of patients do not respond to this form of therapy. Interferon alfa is a glycoprotein with immunomodulatory properties that is also an active agent in the treatment of Sézary syndrome; however, dose-related toxic effects often limit its long-term use. A patient with rapidly advancing Sézary syndrome was treated with a combination of extracorporeal photochemotherapy and low doses of subcutaneous interferon alfa-2b. In addition to the almost complete clearing of his skin lesions and the marked diminution of his extensive lymphadenopathy after 16 weeks of combined therapy, disappearance of the malignant T-cell clone from the peripheral blood was documented by Southern blot analysis. Normalization of the peripheral blood lymphocyte phenotypic profile and an increase in natural killer cell activity were also observed. The excellent clinical response to combined therapy has been sustained, without adverse effects, during 18 months of treatment and 22 months of continued follow-up. The long-term disappearance of the malignant clone from the blood of a patient with Sézary syndrome in response to therapy has not been previously described and thus represents a novel observation. Extracorporeal photochemotherapy and low-dose interferon alfa are well-tolerated therapies that, when combined, may have additive efficacy in the treatment of Sézary syndrome. These results suggest that further exploration of this therapeutic combination is warranted.

Original languageEnglish (US)
Pages (from-to)1535-1540
Number of pages6
JournalArchives of Dermatology
Volume127
Issue number10
DOIs
StatePublished - 1991
Externally publishedYes

Fingerprint

Photopheresis
Interferon-alpha
interferon alfa-2b
Therapeutics
Clone Cells
Poisons
Southern Blotting
Palliative Care
Natural Killer Cells
Glycoproteins
Observation
Lymphocytes
T-Lymphocytes
Skin

ASJC Scopus subject areas

  • Dermatology

Cite this

Combined Therapy for Sézary Syndrome with Extracorporeal Photochemotherapy and Low-Dose Interferon Alfa Therapy : Clinical, Molecular, and Immunologic Observations. / Rook, Alain H.; Prystowsky, Michael B.; Cassin, Maureen; Boufal, Margaret; Lessin, Stuart R.

In: Archives of Dermatology, Vol. 127, No. 10, 1991, p. 1535-1540.

Research output: Contribution to journalArticle

@article{1c70fe5afd7149ad9385d9546794c246,
title = "Combined Therapy for S{\'e}zary Syndrome with Extracorporeal Photochemotherapy and Low-Dose Interferon Alfa Therapy: Clinical, Molecular, and Immunologic Observations",
abstract = "Extracorporeal photochemotherapy is a well-tolerated treatment of palliative benefit for patients with the S{\'e}zary syndrome, but up to 25{\%} of patients do not respond to this form of therapy. Interferon alfa is a glycoprotein with immunomodulatory properties that is also an active agent in the treatment of S{\'e}zary syndrome; however, dose-related toxic effects often limit its long-term use. A patient with rapidly advancing S{\'e}zary syndrome was treated with a combination of extracorporeal photochemotherapy and low doses of subcutaneous interferon alfa-2b. In addition to the almost complete clearing of his skin lesions and the marked diminution of his extensive lymphadenopathy after 16 weeks of combined therapy, disappearance of the malignant T-cell clone from the peripheral blood was documented by Southern blot analysis. Normalization of the peripheral blood lymphocyte phenotypic profile and an increase in natural killer cell activity were also observed. The excellent clinical response to combined therapy has been sustained, without adverse effects, during 18 months of treatment and 22 months of continued follow-up. The long-term disappearance of the malignant clone from the blood of a patient with S{\'e}zary syndrome in response to therapy has not been previously described and thus represents a novel observation. Extracorporeal photochemotherapy and low-dose interferon alfa are well-tolerated therapies that, when combined, may have additive efficacy in the treatment of S{\'e}zary syndrome. These results suggest that further exploration of this therapeutic combination is warranted.",
author = "Rook, {Alain H.} and Prystowsky, {Michael B.} and Maureen Cassin and Margaret Boufal and Lessin, {Stuart R.}",
year = "1991",
doi = "10.1001/archderm.1991.01680090099012",
language = "English (US)",
volume = "127",
pages = "1535--1540",
journal = "JAMA Dermatology",
issn = "2168-6068",
publisher = "American Medical Association",
number = "10",

}

TY - JOUR

T1 - Combined Therapy for Sézary Syndrome with Extracorporeal Photochemotherapy and Low-Dose Interferon Alfa Therapy

T2 - Clinical, Molecular, and Immunologic Observations

AU - Rook, Alain H.

AU - Prystowsky, Michael B.

AU - Cassin, Maureen

AU - Boufal, Margaret

AU - Lessin, Stuart R.

PY - 1991

Y1 - 1991

N2 - Extracorporeal photochemotherapy is a well-tolerated treatment of palliative benefit for patients with the Sézary syndrome, but up to 25% of patients do not respond to this form of therapy. Interferon alfa is a glycoprotein with immunomodulatory properties that is also an active agent in the treatment of Sézary syndrome; however, dose-related toxic effects often limit its long-term use. A patient with rapidly advancing Sézary syndrome was treated with a combination of extracorporeal photochemotherapy and low doses of subcutaneous interferon alfa-2b. In addition to the almost complete clearing of his skin lesions and the marked diminution of his extensive lymphadenopathy after 16 weeks of combined therapy, disappearance of the malignant T-cell clone from the peripheral blood was documented by Southern blot analysis. Normalization of the peripheral blood lymphocyte phenotypic profile and an increase in natural killer cell activity were also observed. The excellent clinical response to combined therapy has been sustained, without adverse effects, during 18 months of treatment and 22 months of continued follow-up. The long-term disappearance of the malignant clone from the blood of a patient with Sézary syndrome in response to therapy has not been previously described and thus represents a novel observation. Extracorporeal photochemotherapy and low-dose interferon alfa are well-tolerated therapies that, when combined, may have additive efficacy in the treatment of Sézary syndrome. These results suggest that further exploration of this therapeutic combination is warranted.

AB - Extracorporeal photochemotherapy is a well-tolerated treatment of palliative benefit for patients with the Sézary syndrome, but up to 25% of patients do not respond to this form of therapy. Interferon alfa is a glycoprotein with immunomodulatory properties that is also an active agent in the treatment of Sézary syndrome; however, dose-related toxic effects often limit its long-term use. A patient with rapidly advancing Sézary syndrome was treated with a combination of extracorporeal photochemotherapy and low doses of subcutaneous interferon alfa-2b. In addition to the almost complete clearing of his skin lesions and the marked diminution of his extensive lymphadenopathy after 16 weeks of combined therapy, disappearance of the malignant T-cell clone from the peripheral blood was documented by Southern blot analysis. Normalization of the peripheral blood lymphocyte phenotypic profile and an increase in natural killer cell activity were also observed. The excellent clinical response to combined therapy has been sustained, without adverse effects, during 18 months of treatment and 22 months of continued follow-up. The long-term disappearance of the malignant clone from the blood of a patient with Sézary syndrome in response to therapy has not been previously described and thus represents a novel observation. Extracorporeal photochemotherapy and low-dose interferon alfa are well-tolerated therapies that, when combined, may have additive efficacy in the treatment of Sézary syndrome. These results suggest that further exploration of this therapeutic combination is warranted.

UR - http://www.scopus.com/inward/record.url?scp=0025924921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025924921&partnerID=8YFLogxK

U2 - 10.1001/archderm.1991.01680090099012

DO - 10.1001/archderm.1991.01680090099012

M3 - Article

C2 - 1929461

AN - SCOPUS:0025924921

VL - 127

SP - 1535

EP - 1540

JO - JAMA Dermatology

JF - JAMA Dermatology

SN - 2168-6068

IS - 10

ER -