PUVA treatment of erythrodermic and plaque-type mycosis fungoides. Ten-year follow-up study

Abel, Elizabeth A.

doi:10.1001/archderm.123.7.897

Cited by 24 publications

(22 citation statements)

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“…It is known from previous studies that PUVA is a highly effective treatment for plaque stage MF, but the majority of patients subsequently relapse. 14,15 Our study confirms that PUVA is an effective treatment for plaque stage MF but also demonstrates that it has no effect on the circulating tumour cells. In our study the circulating T-cell clone detectable prior to PUVA persisted following PUVA, even in those patients with a complete clinical remission.…”

Section: Discussionsupporting

confidence: 72%

A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides

et al. 2004

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PUVA is a well-established and effective treatment for plaque stage mycosis fungoides (MF) but its use is limited on a long-term basis because of the risk of cutaneous carcinogenesis. A further disadvantage is that nonexposed areas (sanctuary sites) often develop persistent disease. Therefore it is important to find alternative methods of treatment. Extracorporeal photopheresis (ECP) is a form of photochemotherapy that involves exposure of white blood cells to UVA with psoralens and can be effective in Sézary syndrome and erythrodermic cutaneous T-cell lymphoma. The aim of this study was to compare the efficacy of PUVA and ECP in the treatment of patients with T2 plaque stage (Stage 1B) MF who had a detectable peripheral blood T-cell clone. The study was of a cross-over design. Sixteen patients were randomized to receive either PUVA twice weekly for 3 months followed by ECP once monthly for 6 months at relapse, or vice-versa. Response was assessed by monthly skin scores and peripheral blood T-cell clonality. Ten patients received PUVA initially and six ECP initially. Eight patients completed the study. Skin scores taken at the completion of each treatment arm in patients who completed the study were 113 units better (confidence interval, 42-184 units) following 3 months PUVA than 6 months ECP (P = 0.002). Peripheral blood T-cell clones were detectable in all patients post-treatment. This study indicates that ECP is not effective in the treatment of plaque stage (1B/T2) MF even in patients with molecular evidence of a peripheral blood T-cell clone. Although PUVA was more effective than ECP, neither treatment modality cleared malignant T-cells from the peripheral blood.

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Section: Discussionsupporting

confidence: 72%

A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides

et al. 2004

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“…In this regard, it should be noted that, although patients with relapsed disease can be retreated, maintenance therapy rarely prevents relapse and should be avoided in order to minimize the total dose. 16,40 8. 6.…”

Section: 5mentioning

confidence: 99%

“…As noted above, maintenance treatments do not prevent relapse and should therefore be avoided in order to minimise total dose and the ensuing risk of squamous cell carcinoma. 16,40 The most common side-effect with methoxsalen alone is nausea, which occurs in approximately 10% of patients. 38 A mild, transient erythema after PUVA therapy is an expected side-effect.…”

mentioning

confidence: 99%

EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome

Trautinger

Knobler

Willemze

et al. 2006

European Journal of Cancer

390

308

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“…Psoralen, which forms DNA adducts upon photoactivation, combined with ultraviolet A (PUVA) causes tumor cell apoptosis and is associated with a complete response rate exceeding 90%, and a prolonged disease-free interval, in patients with stage IA/IB disease [212,213]. In contrast to PUVA, use of either broadband or narrowband ultraviolet B (UVB) does not require psoralen and is associated with a high clinical and pathologic complete response rate, particularly for patients with patch-stage disease [214][215][216][217][218].…”

Section: Treatment Of Limited-stage Mfmentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

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PUVA treatment of erythrodermic and plaque-type mycosis fungoides. Ten-year follow-up study

Cited by 24 publications

References 0 publications

A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides

A randomized cross-over study to compare PUVA and extracorporeal photopheresis in the treatment of plaque stage (T2) mycosis fungoides

EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

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