Therapy of mycosis fungoides with bleomycin

Abstract

A case of mycosis fungoides with universal plaque‐like, dermal infiltration and severe generalized exfoliation is described. This patient had been treated with topical nitrogen mustard, occlusive steroid dressings, total body electron beam therapy, total body orthovoltage superficial radiotherapy, and intensive combination chemotherapy (cyclophosphamide, vincristine, prednisone) during the 6‐year course of his disease, and had become refractory to all modalities. Bleomycin, a new antitumor antibiotic, was administered parenterally at a dose of 10 mg/m2 twice weekly. Over a period of 12 weeks a complete response was achieved and has been maintained 8+ months with a low dose weekly bleomycin and burst cyclophosphamide and prednisone therapy. Toxicity has been minimal. The postulated mechanism for the success of this drug in therapy of this disease entity is discussed.

Current Problems in Mycosis Fungoides and Sezary Syndrome

“…Azaribine (93,94) and bleomycin (Blenoxane®) (95)(96)(97)(98) have been employed more recently and have produced some high response rates of varying duration. Use of systemic corticosteroids has been abandoned because of the brief duration of effec tiveness.…”

“…The combination of nitrogen mustard, vincristine, procarbazine, and prednisone (M OPP) produced a favorable response in three of four patients (3), and a single patient remained clear of lesions for more than a year with the combination of cyclophosphamide, vincristine, and prednisone (COP) (99). Another patient, who had become resistant to a COP program and to other modalities, responded to bleomycin and remained clear of lesions with maintenance therapy with a combination of bleomycin, cyclophospha mide, and prednisone during an 8-month period of observation (97).…”

Mycosis Fungoides: Retrospect, Current Understanding, and Prospect

“…In 1961, Bagshaw et al reported recurrence‐free survivals of 3–11 years from practice of generalized electron‐beam therapy to the skin. Spigel and Coltman reported in 1973 success from parenteral injection of bleomycin for mycosis fungoides refractory to other modalities.…”

Treatment of Mycosis Fungoides With Ok‐432

“…A complete regression was even achieved by the use of topical nitrogen mustard in 50 per cent of cases where the condition had already progressed to the mycotic phase but where involvement of the lymph nodes had not occurred (1). It is generally believed that treatment with X-ray or beta-ray irradiation and anti -cancer chemotherapeutic agents should be undertaken in more advanced cases (2)(3)(4)(5).…”