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

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2008, v.65 no.5, pp.390-395






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Abstract

Background: Since the early 1980s, interferon-alpha (IFN-α) 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-α 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-α 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-α therapy was 56 months (range 12∼66). Two patients showed complete remission at 12 and 36 months after IFN-α injection, respectively. The other three patients showed partial remission, and the number of laser therapy sessions was significantly reducedConclusion: Intermittent IFN-α injection is effective in patients with long-standing RRP and can reduce the number of laser therapy sessions required in their treatment.

keywords
Adjuvant therapy, Interferon-alpha, Recurrent respiratory papillomatosis

Reference

1.

1. Blackledge FA, Anand VK. Tracheobronchial extension of recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol 2000;109:812-8.

2.

2. Derkay CS. Task force on recurrent respiratory papillomas: a preliminary report. Arch Otolaryngol Head Neck Surg 1995;121:1386-91.

3.

3. Kramer SS, Wehunt WD, Stocker JT, Kashima H. Pulmonary manifestations of juvenile laryngotracheal papillomatosis. AJR Am J Roentgenol 1985;144:687-94.

4.

4. Magid MS, Chen YT, Soslow RA, Boulad F, Kernan NA, Szabolcs P. Juvenile-onset recurrent respiratory papillomatosis involving the lung: a case report and review of the literature. Pediatr Dev Pathol 1998;1:157-63.

5.

5. Byrne JC, Tsao MS, Fraser RS, Howley PM. Human papillomavirus-11 DNA in a patient with chronic laryngotracheobronchial papillomatosis and metastatic squamous-cell carcinoma of the lung. N Engl J Med 1987;317:873-8.

6.

6. Lam CW, Talbot AR, Yeh KT, Lin SC, Hsieh CE, Fang HY. Human papillomavirus and squamous cell carcinoma in a solitary tracheal papilloma. Ann Thorac Surg2004;77:2201-2.

7.

7. Rady PL, Schnadig VJ, Weiss RL, Hughes TK, Tyring SK. Malignant transformation of recurrent respiratory papillomatosis associated with integrated human papillomavirus type 11 DNA and mutation of p53. Laryngoscope 1998;108:735-40.

8.

8. Armstrong LR, Derkay CS, Reeves WC. Initial results from the national registry for juvenile-onset recurrent respiratory papillomatosis. RRP Task Force. Arch Otolaryngol Head Neck Surg 1999;125:743-8.

9.

9. Kashima H, Mounts P, Leventhal B, Hruban RH. Sites of predilection in recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol 1993;102:580-3.

10.

10. Avidano MA, Singleton GT. Adjuvant drug strategies in the treatment of recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg 1995;112:197-202.

11.

11. Chhetri DK, Shapiro NL. A scheduled protocol for the treatment of juvenile recurrent respiratory papillomatosis with intralesional cidofovir. Arch Otolaryngol Head Neck Surg 2003;129:1081-5.

12.

12. Gerein V, Rastorguev E, Gerein J, Jecker P, Pfister H. Use of interferon-alpha in recurrent respiratory papillomatosis: 20-year follow-up. Ann Otol Rhinol Laryngol 2005;114:463-71.

13.

13. Healy GB, Gelber RD, Trowbridge AL, Grundfast KM, Ruben RJ, Price KN. Treatment of recurrent respiratory papillomatosis with human leukocyte interferon. Results of a multicenter randomized clinical trial. N Engl J Med 1988;319:401-7.

14.

14. Kimberlin DW. Pharmacotherapy of recurrent respiratory papillomatosis. Expert Opin Pharmacother 2002;3:1091-9.

15.

15. Leventhal BG, Kashima HK, Mounts P, Thurmond L, Chapman S, Buckley S, et al. Long-term response of recurrent respiratory papillomatosis to treatment with lymphoblastoid interferon alfa-N1. Papilloma Study Group. N Engl J Med 1991;325:613-7.

16.

16. Mounts P, Shah KV. Respiratory papillomatosis: etiological relation to genital tract papillomaviruses. Prog Med Virol 1984;29:90-114.

17.

17. Mounts P, Shah KV, Kashima H. Viral etiology of juvenile- and adult-onset squamous papilloma of the larynx. Proc Natl Acad Sci U S A 1982;79:5425-9.

18.

18. McKaig RG, Baric RS, Olshan AF. Human papillomavirus and head and neck cancer: epidemiology and molecular biology. Head Neck 1998;20:250-65.

19.

19. Summersgill KF, Smith EM, Levy BT, Allen JM, Haugen TH, Turek LP. Human papillomavirus in the oral cavities of children and adolescents. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:62-9.

20.

20. Silverberg MJ, Thorsen P, Lindeberg H, Grant LA, Shah KV. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. Obstet Gynecol 2003;101:645-52.

21.

21. Kashima HK, Shah F, Lyles A, Glackin R, Muhammad N, Turner L, et al. A comparison of risk factors in juvenile- onset and adult-onset recurrent respiratory papillomatosis. Laryngoscope 1992;102:9-13.

22.

22. Kashima H, Wu TC, Mounts P, Heffner D, Cachay A, Hyams V. Carcinoma ex-papilloma: histologic and virologic studies in whole-organ sections of the larynx. Laryngoscope 1988;98:619-24.

23.

23. Steinberg BM, Topp WC, Schneider PS, Abramson AL. Laryngeal papillomavirus infection during clinical remission. N Engl J Med 1983;308:1261-4.

24.

24. Thurmond LM, Brand CM, Leventhal BG, Finter NB, Johnston JM. Antibodies in patients with recurrent respiratory papillomatosis treated with lymphoblastoid interferon. J Lab Clin Med 1991;118:232-40.

Tuberculosis & Respiratory Diseases