Intralesional Interferon-α for Conjunctival Mucosa-Associated Lymphoid Tissue Lymphoma Long-term Results

Objective: To report the long-term therapeutic results for patients with conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma who were treated with intralesional injections of interferon-alpha (IFN-alpha). Design: Prospective, nonrandomized, interventional case series. Participants: Twenty eyes of 16 patients with histologically proven conjunctival MALT lymphoma in the absence of systemic disease. Methods: Patients were given 1 500 000 international units (IU) of IFN-alpha (Roferon-A; Roche s.p.a., Milano, Italy) subconjunctivally inside the lesion 3 times weekly for 4 weeks. If there was even a minimal response, a further cycle of 1 000 000 IU 3 times weekly for 4 weeks was administered. Main Outcome Measures: Patients were followed up clinically using slit-lamp examination to determine evidence of tumor disappearance or recurrence. In 10 eyes, an incisional biopsy was performed 6 months after therapy to verify the histologic absence of the lesion. Results: A complete response was obtained in 15 eyes (75%) at the end of first cycle treatment, and in 5 eyes (25%) after further cycles. Seventeen eyes (85%) showed no local recurrence after a median follow-up of 65 months (range, 15-136 months). Three eyes (15%) demonstrated recurrence at variable points after treatment. One patient with stage IIA lymphoma exhibited systemic lymphoma progression. Conclusions: Local immunotherapy with IFN-alpha seems to be an effective and lasting treatment method and provides an alternative to radiotherapy for conjunctival MALT lymphomas. Very few transient side effects were detected. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012;119:494-500 (C) 2012 by the American Academy of Ophthalmology.