Medline ® Abstract for Reference 19
of 'Treatment of early stage (IA to IIA) mycosis fungoides'
Combined modality therapy for cutaneous T-cell lymphoma.
Duvic M, Lemak NA, Redman JR, Eifel PJ, Tucker SL, Cabanillas FF, Kurzrock R
J Am Acad Dermatol. 1996;34(6):1022.
BACKGROUND: Cutaneous T-cell lymphoma (CTCL) may respond to many therapies, but long-term disease-free survival is uncommon. Patients with advanced disease have a median survival of approximately 3 years.
OBJECTIVE: Our purpose was to combine known effective agents sequentially to determine whether we could achieve remission in more patients or for longer duration.
METHODS: Patients with mycosis fungoides (n = 23) or Sézary syndrome (n = 5) were treated with 4 months of recombinant interferon alfa together with isotretinoin, followed by total skin electron beam therapy alone (for stage I to II disease) or preceded by chemotherapy (for stage III to IV disease). Maintenance therapy consisted of interferon for 1 year and topical nitrogen mustard for 2 years.
RESULTS: Twenty-eight patients were treated. The overall response rate (complete and partial remissions) was 82%. Although the median duration of remission was 5 months in patients with stage III to IV disease, two patients remainin complete remission at 39 + and 46 + months. In patients with stage I to II disease the median duration of remission has not been reached at a median follow-up of 18 months. Five patients, all with stage III to IV disease, have died. Overall, the regimen was well tolerated with one treatment-related death from neutropenic sepsis.
CONCLUSION: Combined modality therapy may be effective for the treatment of CTCL with similar response rates to other current therapies.
Department of Medical Specialties, University of Texas, M. D. Anderson Cancer Center, Houston 77030, USA.