Interferon Therapy for Mycosis Fungoides: A Systematic Review_West China Medical Journal

Authors：

WEN Pengfei ¹ , YU Jia ² , MU Chan ² , WU Taixiang ³ ,  WANG Lin ¹

1. Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 2. Department of Dermatovenereology, Southwest Hospital, Chongqing 400038, P.R.China; 3. Division of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding author：

WANG Lin, Email: lkzwl@126.com

Keywords：

干扰素; 蕈样霉菌病; 淋巴瘤; T细胞; 对照试验; 系统评价

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【摘要】　目的　采用系统评价方法，评估干扰素（IFN）治疗蕈样霉菌病（MF）的疗效及安全性。　方法　计算机检索截止2010年5月的Cochrane协作网系统评价方法，纳入所有比较IFN与其他方法治疗MF的随机对照试验及临床对照试验进行质量评价，采用RevMan 5.0.24软件进行Meta分析。　结果　共纳入6篇符合标准的已发表文献，包括142例受试者。Meta分析结果显示: IFN-α单独使用对MF的疗效优于安慰剂组[OR=69.36，95%CI（3.71～1 296.64）]及地精丹方剂[OR=35.53，95%CI（1.78～710.56）]；而IFN-α与胸腺肽[OR=15.11，95%CI（0.71～322.61）]及IFN-α+阿维A酯[OR=3.10，95%CI（0.79～12.12）]的临床疗效差异无统计学意义；IFN-γ联合窄谱中波紫外线（NB-UVB）治疗与单用NB-UVB的临床疗效差异无统计学意义[OR=15.00，95%CI （0.46～485.32）]。90%的患者出现轻度“流感样症状” 的不良反应，多可缓解及消退。　结论　 IFN是目前治疗MF的一线用药，疗效确切且大部分患者耐受性较好。
【Abstract】　Objective　 To evaluate the clinical efficacy and side effects of interferon (IFN) in the treatment of mycosis fungoides (MF) with the method of systematic review. 　Methods　 According to the Cochrane reviewer’s handbook, all the clinical controlled trials involving mycosis fungoides being treated with interferon were retrieved. The Cochrane Collaboration’s software RevMan 5.0.24 was used for meta-analysis.　Results　 Only six papers including 142 patients met the inclusion criteria. Meta-analyses indicated the results as follows: IFN-α monotherapy was more effective than placebo [OR=69.36,95% CI (3.71-1 296.64)] and a traditional Chinese medicine (Di-jing-dan) [OR=35.53,95% CI (1.78-710.56)], but no significant difference was found between INF-α and thymic peptide [OR=15.11, 95% CI (0.71-322.61)], and between IFN-α monotherapy and IFN-α combined with etretinate therapy [OR=3.10, 95% CI (0.79-12.12)]; and there was no significant difference between the efficacy of IFN-γ combined narrowband ultraviolet B (NB-UVB) therapy and that of single NB-UVB therapy [OR=15.00, 95% CI (0.46-485.32)]; Influenza-like side effects occurred to 90% of all the patients, which were usually slight and easy to release.　Conclusion　 Although there are some mild side effects, interferon is safe to treat MF.

Citation： WEN Pengfei,YU Jia,MU Chan,WU Taixiang,WANG Lin. Interferon Therapy for Mycosis Fungoides: A Systematic Review. West China Medical Journal, 2011, 26(4): 551-555. doi: Copy

1.	Jumbou O, N’Guyen JM, Tessier MH, et al. Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa[J]. Br J Dermatol, 1999, 140(3): 427-431.
2.	Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)[J]. Blood, 2007, 110(6): 1713-1722.
3.	Wolff JM, Zitelli JA, Rabin BS, et al. Intralesional interferon in the treatment of early mycosis fungoides[J]. J Am Acad Dermatol, 1985, 13(4): 604-612.
4.	Vonderheid EC, Thompson R, Smiles KA, et al. Recombinant interferon alfa-2b in plaque-phase mycosis fungoides. Intralesional and low-dose intramuscular therapy[J]. Arch Dermatol, 1987, 123(6): 757-763.
5.	陈明华, 肖丽明, 张晓彬, 等. 地精丹方剂加减及免疫调节剂治疗蕈样肉芽肿疗效观察[J]. 临床皮肤科杂志, 2005, 4(12): 850-851.
6.	Dréno B, Claudy A, Meynadier J, et al. The treatment of 45 patients with cutaneous T-cell lymphoma with low doses of interferon-alpha 2a and etretinate[J]. Br J Dermatol, 1991, 125(5): 456-459.
7.	Hugh Z, Thestrup-Pedersen K. Interferon alpha and etretinate combination treatment of cutaneous T-cell lymphoma[J]. J Invest Dermatol, 1990, 95(Suppl 6): 206S-208S.
8.	Shimauchi T, Sugita K, Nishio D, et al. Alterations of serum Th1 and Th2 chemokines by combination therapy of interferon-gamma and narrowband UVB in patients with mycosis fungoides[J]. J Dermatol Sci, 2008, 50(3): 217-225.
9.	Bunn PA, Foon KA, Inde DC, et al. Recombinant leukocyte A interferon: an active agent in advanced cutaneous T-cell lymphomas[J]. Ann Intern Med, 1984, 101(4): 484-487.
10.	Kohn EC, Steis RG, Sausville EA, et al. Phase II trial of intermittent high-dose recombinant interferon alfa-2a in mycosis fungoides and the Sezary syndrome[J]. J Clin Oncol, 1990, 8(1): 155-160.
11.	Olsen EA, Rosen ST, Vollmer RT, et al. Interferon alfa-2a in the treatment of cutaneous T cell lymphoma[J]. J Am Acad Dermatol, 1989, 20(3): 395-407.
12.	Siegel RS, Pandolfino T, Guitart J, et al. Primary cutaneous T-cell lymphoma: review and current concepts[J] . J Clin Oncol, 2000, 18(15): 2908-2925.
13.	Apisarnthanarax N, Duvic M. Cutaneous T-cell lymphoma. New immunodulators[J]. Dermatol Clin, 2001, 19(4): 737-740.
14.	Jumbou O, N’Guyen JM, Tessier MH, et al. Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa[J]. Br J Dermatol, 1999, 140(3): 427-431.
15.	Bunn PA Jr, Hoffman SJ, Norris D, et al. Systemic therapy of cutaneous T-cell lymphomas (mycosis fungoides and the Sézary syndrome)[J]. Ann Intern Med, 1994, 121(8): 592-602.
16.	Chiarion-Sileni V, Bononi A, Fornasa CV, et al. Phase Ⅱ trial of interferon-alpha-2a plus psolaren with ultraviolet light A in patients with cutaneous T-cell lymphoma[J]. Cancer, 2002, 95(3): 569-575.
17.	Trautinger F, Knobler R, Willemze R, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome[J]. Eur J Cancer, 2006, 42(8): 1014-1030.
18.	Zinzani PL, Mazza P, Gherlinzoni F. Beta interferon in the treatment of mycosis fungoides[J]. Haematologica, 1988, 73(6): 547-548.
19.	Kaplan EH, Rosen ST, Norris DB, et al. Phase II study of recombinant human interferon gamma for treatment of cutaneous T-cell lymphoma[J]. J Nati Cancer Inst, 1990, 82(3): 208-212.
20.	Vonderheid EC, Thompson R, Smiles KA, et al. Recombinant interferon alfa-2b in plaque-phase mycosis fungoides. Intralesional and low-dose intramuscular therapy[J]. Arch Dermatol, 1987, 123(6): 757-763.

1. 　Jumbou O, N’Guyen JM, Tessier MH, et al. Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa[J]. Br J Dermatol, 1999, 140(3): 427-431.
2. 　Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)[J]. Blood, 2007, 110(6): 1713-1722.
3. 　Wolff JM, Zitelli JA, Rabin BS, et al. Intralesional interferon in the treatment of early mycosis fungoides[J]. J Am Acad Dermatol, 1985, 13(4): 604-612.
4. 　Vonderheid EC, Thompson R, Smiles KA, et al. Recombinant interferon alfa-2b in plaque-phase mycosis fungoides. Intralesional and low-dose intramuscular therapy[J]. Arch Dermatol, 1987, 123(6): 757-763.
5. 　陈明华, 肖丽明, 张晓彬, 等. 地精丹方剂加减及免疫调节剂治疗蕈样肉芽肿疗效观察[J]. 临床皮肤科杂志, 2005, 4(12): 850-851.
6. 　Dréno B, Claudy A, Meynadier J, et al. The treatment of 45 patients with cutaneous T-cell lymphoma with low doses of interferon-alpha 2a and etretinate[J]. Br J Dermatol, 1991, 125(5): 456-459.
7. 　Hugh Z, Thestrup-Pedersen K. Interferon alpha and etretinate combination treatment of cutaneous T-cell lymphoma[J]. J Invest Dermatol, 1990, 95(Suppl 6): 206S-208S.
8. 　Shimauchi T, Sugita K, Nishio D, et al. Alterations of serum Th1 and Th2 chemokines by combination therapy of interferon-gamma and narrowband UVB in patients with mycosis fungoides[J]. J Dermatol Sci, 2008, 50(3): 217-225.
9. 　Bunn PA, Foon KA, Inde DC, et al. Recombinant leukocyte A interferon: an active agent in advanced cutaneous T-cell lymphomas[J]. Ann Intern Med, 1984, 101(4): 484-487.
10. 　Kohn EC, Steis RG, Sausville EA, et al. Phase II trial of intermittent high-dose recombinant interferon alfa-2a in mycosis fungoides and the Sezary syndrome[J]. J Clin Oncol, 1990, 8(1): 155-160.
11. 　Olsen EA, Rosen ST, Vollmer RT, et al. Interferon alfa-2a in the treatment of cutaneous T cell lymphoma[J]. J Am Acad Dermatol, 1989, 20(3): 395-407.
12. 　Siegel RS, Pandolfino T, Guitart J, et al. Primary cutaneous T-cell lymphoma: review and current concepts[J] . J Clin Oncol, 2000, 18(15): 2908-2925.
13. 　Apisarnthanarax N, Duvic M. Cutaneous T-cell lymphoma. New immunodulators[J]. Dermatol Clin, 2001, 19(4): 737-740.
14. 　Jumbou O, N’Guyen JM, Tessier MH, et al. Long-term follow-up in 51 patients with mycosis fungoides and Sezary syndrome treated by interferon-alfa[J]. Br J Dermatol, 1999, 140(3): 427-431.
15. 　Bunn PA Jr, Hoffman SJ, Norris D, et al. Systemic therapy of cutaneous T-cell lymphomas (mycosis fungoides and the Sézary syndrome)[J]. Ann Intern Med, 1994, 121(8): 592-602.
16. 　Chiarion-Sileni V, Bononi A, Fornasa CV, et al. Phase Ⅱ trial of interferon-alpha-2a plus psolaren with ultraviolet light A in patients with cutaneous T-cell lymphoma[J]. Cancer, 2002, 95(3): 569-575.
17. 　Trautinger F, Knobler R, Willemze R, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome[J]. Eur J Cancer, 2006, 42(8): 1014-1030.
18. 　Zinzani PL, Mazza P, Gherlinzoni F. Beta interferon in the treatment of mycosis fungoides[J]. Haematologica, 1988, 73(6): 547-548.
19. 　Kaplan EH, Rosen ST, Norris DB, et al. Phase II study of recombinant human interferon gamma for treatment of cutaneous T-cell lymphoma[J]. J Nati Cancer Inst, 1990, 82(3): 208-212.
20. 　Vonderheid EC, Thompson R, Smiles KA, et al. Recombinant interferon alfa-2b in plaque-phase mycosis fungoides. Intralesional and low-dose intramuscular therapy[J]. Arch Dermatol, 1987, 123(6): 757-763.

West China Medical Journal

Interferon Therapy for Mycosis Fungoides: A Systematic Review

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