RESUMO
Background: Sezary syndrome (SS) prognostic factors are not well defined because of the rarity of this disease. The specific goal of this prospective study was to asses by multivariate analysis the predictive value with respect to survical of series of clinical, haematological ans immunological parameters taken at SS diagnosis. Patients and methods: A cohort of 62 SS patientsdiagnosed and followed since 1975 was examined, and 51 were included in the multivariate analysis model. Results: The median survical time was 31 months (range: 1 month-15.7+ years), and the five-year survical rate 33.5%. The following variables were found by univariate analysis to be associated with a poor prognosis at the time of SS diagnosis: previous history of mycosis fungoides (P = 0.013), high number of circulating leukocytes (P = 0.001), Sezary cells (SC) (P 1; n = 20) are characterized by an aggressive disase course not modifiable by traditional therapies (five-year survical: 5%
Assuntos
Humanos , Linfócitos T/citologia , Linfócitos T/química , Síndrome de Sézary/imunologia , Síndrome de Sézary/sangue , Linfócitos T/ultraestrutura , PrognósticoRESUMO
Recently, Khayat et al. reported that high-dose recombinent interleukin-2 (rIL-2) i.v. may induce tumour regression in metastatic melanoma patients through an association with cisplatin (CDDP) and alpha-interferon (alpha-IFN). Treatment-related toxicities are, however, important. Previous studies have demonstrated that rIL-2 toxicity may be reduced through a subcutaneous injection. In order to evaluate the effectiveness of low subcutaneous rIL-2 doses in a chemoimmuno-hormonotherapeutic combination, 36 metastatic melanoma patients were treated with CDDP, rIL-2, alpha-IFN and tamoxifen (TAM). The overall response rate was 47.2% five patients had complete response (14%), 12 partial response (33%) and 13 stable disease (36%). Median response duration was 6.4 months (range: 2-29+). Median overal survival was 10 months (range: 3-36+). The CDDP/rIL-2/alpha-IFN/TAM regimen was effective both on soft tissue and visceral metastases. Toxicity was low and patient management did not require an intensive care unit. A statistically significant increase in both percentage and absolute values of lymphocytes, eosinophilis, CD3+/CD4+, CD5+, CD16/56 + and HLA-DR+ cells wasfound in all patients after two treatment courses. This study shows that lower doses of subcutaneous rIL-2, as well as CDDP and alpha-IFN, associated with TAM, may have similar anticancer efficacy with respect to Khayat's schedule but lower toxicity