Prognosis, clinical outcomes and quality of life issues in cutaneous T-cell lymphoma

Demierre, Marie‐France; Kim, Youn H; Zackheim, Herschel S.

doi:10.1016/s0889-8588(03)00111-4

Cited by 45 publications

(51 citation statements)

References 96 publications

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“…Our previous results suggest that the disease has an impact on emotional well being that is related mostly to disease stage. [2][3][4][5] Emotional well being includes anger, sadness, depression, embarrassment, frustration, and worries of disease worsening and death. 5 It is clear that all of these emotions are relevant to the HRQOL of patients with CTCL.…”

Section: Discussionmentioning

confidence: 99%

“…The most common form, mycosis fungoides (MF), can cause severe suffering with adverse affects across multiple dimensions of health-related quality of life (HRQOL). 2,3 MF is often a chronic disease, and multiple therapies are available, each with varying side-effect profiles. Those patients with MF who pro-gress to the tumor stage or who have the leukemic variant, Sézary syndrome, often die of their malignancy.…”

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confidence: 99%

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Significant impact of cutaneous T‐cell lymphoma on patients' quality of life

Demierre

Gan

Jones

et al. 2006

Cancer

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154

141

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BACKGROUND.Cutaneous T‐cell lymphoma (CTCL) can have a profound impact on a patient's health‐related quality of life; however, little is known about its actual impact. The authors evaluated patients' perspectives on the impact of CTCL on physical functioning, lifestyle, emotional well being, and satisfaction with treatment.METHODS.A 4‐page, self‐administered questionnaire was mailed and made available online in March 2005 to the entire United States membership of the Mycosis Fungoides Foundation (n = 930 members). Outcome measures were patients' perspectives on the psychosocial impact of CTCL and the management of their disease.RESULTS.The response rate was 68%, and 93.6% of respondents were white. The majority of respondents had mycosis fungoides (89%). Respondents were bothered by skin redness (94%) and by the extent of symptoms that affected their choice of clothing (63%). For most patients, the disease had a functional impact, rendering them tired or affecting their sleep. Health distress was reported by almost all respondents, with 94% reporting that they worried about the seriousness of their disease and 80% worrying about dying from the disease. Sixty‐two percent of respondents reported that their disease made them feel unattractive, 85% reported that their treatment made their disease seem more manageable, but 61% reported that they felt burdened financially by their disease.CONCLUSIONS.The high response rate and patients' responses to the survey provided compelling evidence that patients believed CTCL had a profound and severe impact on their functioning, emotional, and social well being. A striking health distress was prevalent in almost all respondents. Although the majority of patients reported that treatments made their disease more manageable, a significant proportion reported that they felt burdened financially by their disease. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Significant impact of cutaneous T‐cell lymphoma on patients' quality of life

Demierre

Gan

Jones

et al. 2006

Cancer

Self Cite

154

141

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“…Cutaneous T-cell lymphomas (CTCL) are a group of nonHodgkin's lymphoma (NHL) caused by malignant, skin-homing T cells (1)(2)(3). The most common variants are mycosis fungoides (MF) and Sézary syndrome (SS).…”

Section: Introductionmentioning

confidence: 99%

Constitutive Activation of Signal Transducers and Activators of Transcription Predicts Vorinostat Resistance in Cutaneous T-Cell Lymphoma

Fantin

Loboda²,

Paweletz³

et al. 2008

Cancer Research

161

127

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Vorinostat is a histone deacetylase inhibitor that induces differentiation, growth arrest, and/or apoptosis of malignant cells both in vitro and in vivo and has shown clinical responses in f30% of patients with advanced mycosis fungoides and Sézary syndrome cutaneous T-cell lymphoma (CTCL). The purpose of this study was to identify biomarkers predictive of vorinostat response in CTCL using preclinical model systems and to assess these biomarkers in clinical samples. The signal transducer and activator of transcription (STAT) signaling pathway was evaluated. The data indicate that persistent activation of STAT1, STAT3, and STAT5 correlate with resistance to vorinostat in lymphoma cell lines. Simultaneous treatment with a pan-Janus-activated kinase inhibitor resulted in synergistic antiproliferative effect and down-regulation of the expression of several antiapoptotic genes. Immunohistochemical analysis of STAT1 and phosphorylated tyrosine STAT3 (pSTAT3) in skin biopsies obtained from CTCL patients enrolled in the vorinostat phase IIb trial showed that nuclear accumulation of STAT1 and high levels of nuclear pSTAT3 in malignant T cells correlate with a lack of clinical response. These results suggest that deregulation of STAT activity plays a role in vorinostat resistance in CTCL, and strategies that block this pathway may improve vorinostat response. Furthermore, these findings may be of prognostic value in predicting the response of CTCL patients to vorinostat. [Cancer Res 2008;68(10):3785-94]

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“…4 MF itself, as a dermatologic disease and as a malignancy, can severely affect the quality of life. [7][8][9] Because of the many treatment options available for patients with MF, treatment is often individualized based on patient preferences and characteristics, cost, and availability of referral centers and facilities. 10 This study on 13 patients is a small sample of patients having failed at least 3 prior therapies (but not TSEBT) before referral, and in this sense it is a pilot study to test the feasibility of asking these types of questions, and to make some preliminary observations.…”

Section: Discussionmentioning

confidence: 99%