isotretinoin and Lymphoma--Non-Hodgkin

Interferon-alpha (IFN-alpha) and retinoids have shown nonoverlapping toxicity and each has shown antitumor activity in patients with lymphoma. The aim of the current study was to assess the toxicity, safety, and efficacy of IFN-alpha combined with isotretinoin in patients with advanced, refractory lymphoid malignancies.. Adults with biopsy-proven advanced lymphoid malignancy were treated. Patients with compromised bone marrow function (platelet counts as low as 30 x 10(9)/L) were eligible. Treatment was comprised of IFN-alpha at a starting daily dose of 3 mega units subcutaneously and isotretinoin orally starting at a dose of 1 mg/kg daily in 2 divided doses.. Forty-four patients were evaluable. Their median age was 57 years (range, 18-82 years). Eighteen patients had advanced cutaneous T-cell lymphoma, 6 patients had peripheral T-cell lymphoma, 14 patients had Hodgkin disease, and 6 patients had a variety of other lymphoid malignancies. Patients with Hodgkin disease had received a median of 6 previous therapies (range, 3-12 therapies) and patients with other lymphoid malignancies had received a median of 4 previous therapies (range, 1-9 therapies). The median duration of treatment was 4 months (range, 0.25-38 months). The overall response rate was 38.6% (complete response in 5 patients [11.3%] and partial response in 12 patients [27.3%]). The median response duration was 3 months (range, 1-95+ months). The most common toxicities were low-grade fever, flu-like symptoms, and fatigue (IFN-alpha effects); dry mouth and skin and hypertriglyceridemia (cis-retinoic acid effects); and thrombocytopenia (which generally occurred in patients with low baseline platelet counts).. IFN-alpha and isotretinoin combination therapy had antitumor activity and was well tolerated in heavily pretreated patients with lymphoid malignancies.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biopsy, Needle; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Hodgkin Disease; Humans; Interferon-alpha; Isotretinoin; Lymphoma, Non-Hodgkin; Male; Maximum Tolerated Dose; Middle Aged; Neoplasm Staging; Prospective Studies; Risk Assessment; Survival Analysis; Treatment Outcome

Discussions from a recent cancer conference held in May of 1995 are summarized in the following areas: 1) the effect of mitoguazone in relapsed non-Hodgkin's lymphoma; 2) the addition of ddI or ddC to chemo for advanced Kaposi's sarcoma (KS); 3) progress in use of three new anti-KS agents; 4) the effectiveness of phototherapy as palliation for KS; and 5) reasons why HIV prevalence is probably underestimated in women. Additionally, the paper reviews the Lymphoma Project Report which analyzed the epidemiology, pathogenesis, diagnosis, clinical manifestations, molecular characteristics, prognostic factors, and treatment of AIDS lymphoma. The following were among the findings: a regimen of doxorubicin, bleomycin, and vincristine with either ddI or ddC was well tolerated and evoked antitumor responses in patients with KS; 9-cis-retinoic acid and beta-human chorionic gonadotropin can induce remission of KS lesions; photodynamic therapy is an effective palliative therapy for some people with KS, but doses above 300 joules/cm2 result in scarring; and most American women who die of cervical cancer probably also have HIV infection according to a clinician from State University of New York in Brooklyn. The article concludes with a discussion of the differences between the focus of HIV research and HIV meetings for the ASCO assembly and the AIDS community.

Topics: Acquired Immunodeficiency Syndrome; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Chorionic Gonadotropin; Female; Humans; Isotretinoin; Lymphoma, AIDS-Related; Lymphoma, Non-Hodgkin; Mitoguazone; Paclitaxel; Palliative Care; Photochemotherapy; Recurrence; Sarcoma, Kaposi; Uterine Cervical Neoplasms

Oral retinoids are effective in the treatment of patients with a variety of malignant and nonmalignant skin disorders, including mycosis fungoides. We treated six patients with cutaneous T-cell lymphomas with isotretinoin 1 to 2 mg/kg/d. All patients experienced symptomatic relief (fading of skin lesions and disappearance of pruritus) within two to eight weeks of starting the drug therapy; pretreatment and posttreatment biopsy specimens were unchanged. Adverse effects were minor and primarily consisted of drying of the mucous membranes. We conclude that isotretinoin is a well-tolerated, easily administered drug that provides good palliation of symptoms and signs associated with cutaneous T-cell lymphoma in patients who are unable or unwilling to comply with standard therapy.

Topics: Aged; Female; Humans; Isotretinoin; Lymphoma, Non-Hodgkin; Male; Middle Aged; Skin Neoplasms; T-Lymphocytes; Tretinoin; Xerostomia