The use of pegylated interferon a-2a in a cohort of Greek patients with mycosis fungoides

IFN a with its cytotoxic and immunological effects on tumorous T cells has been introduced in the treatment of cutaneous T-cell lymphoma since the 1980s. The reported experience (average response rates 45–80%, further improved with combination schemes) is mostly based on the use of the recombinant IFN a-2a or IFN a-2b. However, these interferon formulations are no longer commercially available in Europe and therefore, the pegylated analogue (pegylated IFN a-2a, Pegasys;Hoffmann-La Roche) has been currently used to treat CTCLs. The purpose of the current study was to evaluate the efficacy and safety profile of pegylated IFN a-2a in the treatment of mycosis fungoides (MF). We collected data from three referral Cutaneous Lymphoma Units in Greece, covering a 2-year period, before COVID -19 pandemic restrictions. The primary endpoint was to determine the effectiveness of peg IFN as measured by the overall response rate (RR) in this cohort. Secondary endpoints were difference in RRs with respect to gender, disease stage, presence of folliculotropism and treatment features, time to best response, duration of response, drug survival, reasons for drug discontinuation and safety profile. Statistical analysis of the data was performed using the Statistical Package for Social Sciences (SPSS), version 15.0 (SPSS, Inc., Chicago, IL, USA). Overall, 31 patients were included. Most patients (n=12;38.7%) had ΙΒ-stage disease at peg IFN initiation. In all, 11 (35.5%) patients received PegIFN monotherapy, while 20 (64.5%) subjects on peg IFN concomitantly received bexarotene, acitretin, methotrexate or topical chemotherapy. PegIFN was administered in the majority of patients as third or fourth line therapy (21/31). A 54.8% (17/31) overall response rate was noted: 9.7% and 45.2% for CR and PR, respectively. In our cohort, no differences in RRs with respect to gender (p=0.427), disease stage (p=0.179) or presence of folliculotropism (p=0.532) was observed. Peg IFN was not more effective as monotherapy than as a subsequent agent with respect to overall response (p=0.680). Mean time to best response was 7.29±4.99 months. Treatment dose was reduced in 8 (25.8%) cases due to drug intolerance. Adverse effects were recorded in 21 (67.7%) cases with leukopenia (n=16;76.1%), fatigue (n=9;42.8%) and anemia (n=4;19.0%) being the most recorded. Overall, peg IFN may be considered an effective additional regimen in the treatment of MF, stage IB or higher, with a rather good tolerance and safety profile. [ABSTRACT FROM AUTHOR] Copyright of European Journal of Cancer is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Management of primary cutaneous lymphomas during the COVID-19 pandemic.

Primary cutaneous lymphomas are defined as a heterogenic group of T- and B-cell non-Hodgkin lymphomas that present initially in the skin. Patients with primary cutaneous lymphomas are at a higher risk for developing complications in case of infection with the novel coronavirus severe acute respiratory syndrome coronavirus 2. The coronavirus disease 2019 (COVID-19) pandemic has affected the established diagnostic approach, staging, and therapeutic guidelines in patients with primary cutaneous lymphomas. In the light of the current global health crisis, management of primary cutaneous lymphomas needs to be adjusted. The key to achieving this is to balance the optimal control of the lymphoma, with a minimal increase of the personal risk for COVID-19 exposure and complications.

Impact of the COVID-19 pandemic on the course and management of chronic inflammatory immune-mediated skin diseases: What's the evidence?

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, medical professionals have been overwhelmed by questions beyond the infection itself. In dermatology practice, clinicians have been facing difficulties about the management of chronic immune-mediated skin diseases. Issues arose, such as the grade of immunosuppression or immunomodulation, discontinuation or modification of treatment, and initiation of new treatments. In this comprehensive review, we present the current evidence about the course and management of chronic inflammatory dermatoses during the COVID-19 pandemic, focusing on psoriasis, atopic dermatitis, and hidradenitis suppurativa.