Tuberc Respir Dis.  2008 Nov;65(5):390-395.

Efficacy of Long-term Interferon-alpha Therapy in Adult Patients with Recurrent Respiratory Papillomatosis

• Nam HS
• Koh WJ
• Suh GY
• Chung MP
• Kwon OJ
• Kim H

Abstract

BACKGROUND: Since the early 1980s, interferon-alpha (IFN-alpha) has been used as adjuvant therapy in pediatric patients with recurrent respiratory papillomatosis (RRP). However, its efficacy in adults needs to be validated. Since 2002, Samsung Medical Center's guidelines have mandated regular injection of IFN-alpha in patients with RRP to prevent recurrence. To evaluate these guidelines, patient data were investigated.
METHODS
Five patients diagnosed as having RRP by bronchoscopy and histopathology were included. After initial bronchoscopic intervention, including laser cauterization, all patients received subcutaneous injection of 6 million units of IFN-alpha every 2 months. Further bronchoscopic intervention was carried out as needed. Patients were regularly evaluated using bronchoscopy or computed tomography.
RESULTS
The median age of the patients was 44 years (range 13~68), and the median duration of papillomatosis was 31 years (range 1~45). Three and two patients had juvenile-onset and adult-onset disease, respectively. Two patients had a history of tracheostomy at the time of diagnosis. The median duration of IFN-alpha therapy was 56 months (range 12~66). Two patients showed complete remission at 12 and 36 months after IFN-alpha injection, respectively. The other three patients showed partial remission, and the number of laser therapy sessions was significantly reduced.
CONCLUSION
Intermittent IFN-alpha injection is effective in patients with long-standing RRP and can reduce the number of laser therapy sessions required in their treatment.

Keyword

Adjuvant therapy; Interferon-alpha; Recurrent respiratory papillomatosis

MeSH Terms

Adult
Bronchoscopy
Humans
Injections, Subcutaneous
Interferon-alpha
Laser Therapy
Papilloma
Papillomavirus Infections
Recurrence
Respiratory Tract Infections
Tracheostomy
Interferon-alpha
Papillomavirus Infections
Respiratory Tract Infections

Figure

• 

  Figure 1 Representative photographs of papillomas following IFN-α therapy. Bronchoscopy of 38-year-old male patient showed a huge papilloma in the upper trachea (left). After laser treatment, IFN-α injection was started and the papilloma showed marked regression 4 (middle) and 5 years after (right) IFN-α injection.

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