Actas Dermo-Sifiliográficas Actas Dermo-Sifiliográficas
Actas Dermosifiliogr.2009;100:571-85 - Vol. 100 Num.7 DOI: 10.1016/S1578-2190(09)70125-8
Original articles
Experience in the Treatment of Cutaneous In-Transit Melanoma Metastases and Satellitosis With Intralesional Interleukin-2
Esperiencia en el Tratamiento de Satelitosis y Metástasis Cutáneas en Tránsuito de Melanoma con Interleucina 2 Intralesional
L.A. Dehesa, J. Vilar-Alejo, P. Valerón-Almazán, G. Carretero,
Servicio de Dermatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
Accepted 13 October 2008
Abstract
Introduction

Although metastatic melanoma has a poor prognosis, cutaneous metastases represent a special case given their ready accessibility, making it possible for dermatologists to apply local treatment. We report our experience with intralesional treatment with interleukin (IL) 2 in 7 patients with cutaneous metastases from malignant melanoma.

Material and methods

A total of 244 lesions in 7 patients with satellitosis and/or cutaneous metastases from malignant melanoma were treated with intralesional IL-2 twice a week. The maximum dose in each patient ranged from 3 to 18 million units per session, according to the number and size of lesions.

Results

Complete or partial remission was achieved in almost all lesions (95.9% and 3.7%, respectively). Only 1 lesion (0.4%)—the largest and located subcutaneously—did not respond to intralesional treatment and required alcoholization and subsequent surgical removal to achieve cure. All partial responses occurred in subcutaneous lesions larger than 2 cm. Treatment was well tolerated with only a few mild side effects (grade 1-2).

Conclusions

IL-2 may be an effective and well-tolerated treatment option in patients with satellitosis and cutaneous metastases from melanoma. Lesions smaller than 2 cm and located in the epidermis or superficial dermis respond better than those larger than 2 cm or located in the subcutaneous cellular tissue. More studies are necessary to establish appropriate doses and regimens.

Resumen
Introducción

A pesar del mal pronóstico del melanoma metastásico, las metástasis cutáneas constituyen un grupo especial por su fácil accesibilidad que lo hace susceptible al abordaje local por parte del dermatólogo. Describimos nuestra experiencia de tratamiento intralesional con interleucina 2 (IL-2) en 7 pacientes con metástasis cutáneas de melanoma maligno.

Material y métodos

Un total de 244 lesiones en 7 pacientes con satelitosis y/o metástasis cutáneas de melanoma maligno han sido tratadas con IL-2 intralesional administrada dos veces a la semana. Las dosis máximas por pacientes variaron entre los 3 y 18 millones de unidades/sesión, en función del número y tamaño de las lesiones.

Resultados

Se han obtenido remisiones completas (95,9%) o parciales (3,7%) en la gran mayoría de lesiones tratadas, una sola lesión (0,4%), de localización subcutánea y de mayor tamaño, no respondió al tratamiento intralesional y precisó de alcoholización y posterior extirpación quirúrgica para su resolución. Todas las respuestas parciales se observaron en lesiones de localización subcutánea y mayores de 2 cm. El tratamiento fue bien tolerado, con escasos efectos secundarios de intensidad leve (grado 1-2).

Conclusiones

La IL-2 puede ser una buena opción para el tratamiento de pacientes con satelitosis y metástasis cutáneas de melanoma con elevada eficacia y escasos efectos secundarios. Las lesiones menores de 2 cm y localizadas en epidermis o dermis superficial responden mejor que las mayores de 2 cm o localizadas en el tejido celular subcutáneo. Son necesarios más estudios para establecer las dosis y pautas de tratamiento adecuadas.

Palabras clave
interleucina 2, melanoma maligno, metástasis cutáneas, terapia intralesional
Key words
interleukin 2, malignant melanoma, cutaneous metastasis, intralesional therapy
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Correspondence: Servicio de Dermatología. Hospital Universitario de Gran Canaria Dr. Negrín. Barranco de La Ballena, s/n. 35012 Las Palmas de Gran Canaria, Spain.
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Actas Dermosifiliogr.2009;100:571-85 - Vol. 100 Num.7 DOI: 10.1016/S1578-2190(09)70125-8