Ultraviolet-B Phototherapy for Early-Stage Cutaneous T-cell Lymphoma

Ramsay, David L.; Lish, Karen M.; Yalowitz, Cynthia B.; Soter, Nicholas A.

doi:10.1001/archderm.1992.01680170063007

Cited by 129 publications

(63 citation statements)

References 13 publications

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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]. Malignant T cells are radiosensitive.…”

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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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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“…1,15 For instance, Ramsay et al 1 showed in a retrospective nonrandomized study of 37 patients with early (stages IA-IIB) cutaneous T-cell lymphoma (CTCL) that broadband UV-B treatment produced complete clearance in 25 (83%) of 30 patients with stage I CTCL after a median time of 5 months, but produced no response in any patients with stage II CTCL. Among the patients who achieved complete remission, 5 (20%) had a relapse after a median time of 5 months (range, 1-33 months); in 2 of these patients, relapse occurred during UV-B maintenance therapy, which was given to all patients for at least 3 months.…”

Section: Commentmentioning

confidence: 99%

Narrowband (311-nm) UV-B Therapy for Small Plaque Parapsoriasis and Early-Stage Mycosis Fungoides

Hofer

Cerroni²,

Kerl³

et al. 1999

Arch Dermatol

131

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“…†Present study. ‡Taken from Hoppe et al 16 §Taken from Zackheim et al 17 Taken from Hermann et al 13 ¶Taken from Ramsay et al 18 #Taken from Hoppe.…”

Section: Commentmentioning

confidence: 99%

Topical Corticosteroids for Mycosis Fungoides

Zackheim¹,

Kashani‐Sabet²,

Amin³

1998

Arch Dermatol

209

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Setting: Academic referral center, Veterans Affairs Medical Center, and private practice.Patients: Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination. Intervention: Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment. Main Outcome Measures: Response to treatment and side effects.Results: The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy speciments were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1. Conclusion:Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.

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Ultraviolet-B Phototherapy for Early-Stage Cutaneous T-cell Lymphoma

Cited by 129 publications

References 13 publications

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

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

Narrowband (311-nm) UV-B Therapy for Small Plaque Parapsoriasis and Early-Stage Mycosis Fungoides

Topical Corticosteroids for Mycosis Fungoides

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