Treatment of Cutaneous T-Cell Lymphoma With Combined Immunomodulatory Therapy

Suchin, Karen Rebecca; Cucchiara, Andrew J.; Gottleib, Scott L.; Wolfe, Jonathan; DeNardo, Barbara J.; Macey, William H.; Bromley, Patricia; Vittorio, Carmela C.; Rook, Alain H.

doi:10.1001/archderm.138.8.1054

Cited by 112 publications

(92 citation statements)

References 33 publications

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“…For example, in a cohort of 51 patients (42 of which had advancedstage disease) treated with single-agent, low-dose, interferon-alpha, responses were observed in 34 (67%), 21 (41%) of which were complete and maintained long-term in nine patients [288]. Similarly, in a cohort of 47 patients with stage III/IV disease, 89% of which had peripheral blood involvement, a response rate exceeding 80% was observed in those treated with a combination of ECP and interferonalpha [302]. Interferon-alpha is associated with myelosuppression, transaminitis and dose-limiting flu-like side effects, particularly at higher doses.…”

Section: Interferon-alphamentioning

confidence: 96%

“…Responses, which may be achieved within a few months, are observed in patients with tumor-stage MF and SS. Furthermore, interferon-alpha may be successfully combined with a number of other therapeutic modalities, including PUVA, bexarotene, chemotherapy and ECP, which are frequently utilized in the management of these patients [289][290][291][292][293][294][295][296][297][298][299][300][301][302]. For example, in a cohort of 51 patients (42 of which had advancedstage disease) treated with single-agent, low-dose, interferon-alpha, responses were observed in 34 (67%), 21 (41%) of which were complete and maintained long-term in nine patients [288].…”

Section: Interferon-alphamentioning

confidence: 99%

“…In addition, patients without profound immune deficiencies, reflected by normal or near-normal cytotoxic T-cell and CD4/CD8 values and the absence of prior exposure to systemic chemotherapy, may be more likely to respond to therapy [310,313]. While effective as monotherapy, ECP has also been combined with other therapeutic strategies, including interferon, bexarotene and TSEBT [292,302,312,[315][316][317].…”

Section: Extracorporeal Photophoresismentioning

confidence: 99%

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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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Section: Interferon-alphamentioning

confidence: 96%

Section: Interferon-alphamentioning

confidence: 99%

Section: Extracorporeal Photophoresismentioning

confidence: 99%

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

Wilcox

2011

American J Hematol

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“…76 In the study by Suchin and colleagues, 89% of a consecutive sample of 47 patients had circulating malignant T cells. 126 ECP monotherapy resulted in a 75% ORR and median survival of 66 months. The authors also reported an increase in the ORR and survival duration when ECP was combined with immunostimulatory agents such as IFN-a.…”

Section: Chemotherapy Many Different Chemotherapeuticmentioning

confidence: 96%

“…77 Suchin and colleagues observed a 75% ORR in a retrospective cohort study, and Gottlieb and colleagues reported a CR rate of 25% and a PR rate of 46% from a retrospective chart review of 28 patients with stage III or IV disease. 126,127 In addition, ECP has minimal side-effects. 77,128 Zic and colleagues also reported a CR rate of 25% and PR rate of 25% in a cohort of 20 patients.…”

Section: Retinoids Plus Puva Thomsen and Colleagues Re-mentioning

confidence: 99%