Therapeutic effect of narrow band - utraviolet B combined with interferon - alpha - 2b for the treatment of mycosis fungoides and its correlation with Treg/Th17 cells

Abstract

Objective To evaluate the therapeutic effect of narrow band-ultraviolet B (NB-UVB) alone or in combination with interferon-alpha-2b (INF - alpha-2b) for mycosis fungoides (MF), and to assess the correlation between the therapeutic effect and peripheral blood regulatory T (Treg)/T helper type 17 (Th17) cells. Methods Thirty-three patients with stage IA to IIA MF were randomly divided into two groups: NB-UVB group (n = 15) receiving NB-UVB radiation alone, combined group (n = 18) treated with NB-UVB radiation and intramuscular injection of INF-alpha-2b. Ten healthy volunteers were selected as the control group. Peripheral blood samples were collected before and 9 months after the start of treatment. Flow cytometry was performed to determine the percentages of Treg cells and Th17 cells. Statistical analysis was carried out by using t test, one-way analysis of variance, and Fisher's exact test. Results The average treatment duration was 9 months among these patients. Therapeutic outcomes were significantly better in the combined group than in the NB-UVB group (P= 0.023). Among the 15 patients in the NB-UVB group, 6 achieved complete remission, 3 partial remission, 6 showed no response; of the 18 patients in the combined group, 12 experienced complete remission, 5 partial remission, and 1 showed no response. Before the treatment, the percentages of both Treg and Th17 cells in peripheral blood were significantly higher in the NB-UVB group and combined group than in the control group (both P 0.05). After the treatment, the percentages of both Treg and Th17 cells in the NB - UVB group and combined group significantly decreased compared with those before the treatment, but were still higher than those in the control group (both P 0.05) after the treatment. Conclusions The therapeutic effect of NB-UVB radiation combined with intramuscular INF-alpha-2b is superior to that of NB - UVB radiation alone for MF, which may be associated with the degree of decrease in peripheral blood Treg and Th17 cells. Key words: Ultraviolet therapy; Interferon-alpha; Treatment outcomes; T-lymphocytes, regulatory; Th17 cells; Mycosis fungoides