scholarly journals Long-Term Efficacy of Psoralen Plus Ultraviolet a Irradiation and Low-Dose Interferon-Alpha Therapy According to Conventional and Emerging Clinical Endopoints of Early Stage Cutaneous T Cell Lymphoma

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2462-2462
Author(s):  
Serena Rupoli ◽  
Gaia Goteri ◽  
Erika Morsia ◽  
Elena Torre ◽  
Kimberly Blaine Garvey ◽  
...  
Keyword(s):  
T Cell ◽  
Median Time ◽  
Partial Remission ◽  
Low Dose ◽  
Cell Lymphoma ◽  
Early Stage ◽  
T Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Ultraviolet A

Abstract Introduction: Patients with early stage Cutaneous T cell Lymphoma (CTCL) usually have a benign and chronic disease course. Refractoriness under skin directed therapies and/or more extensive disease pose some therapeutic changes. Using the combination of psoralen plus ultraviolet A irradiation (PUVA) and low-dose Interferon-α (INF), the principal treatment goal is to keep confined the disease to the skin, preventing disease progression. Methods: We carry out a prospective data on 87 patients with early stage IA to IIA MF treated with low-dose IFN-α2b and PUVA, enrolled from 1997 to 2010. We collected data regarding clinical characteristics of MF, efficacy and outcome. Subcutaneous IFN-α2b was administered 1.5 MU/day during the first week; in the second week the dose was increased to 3MU/day. PUVA irradiation was started on the 3th week with IFN-α2b 3 MU 3 times weekly until CR, of for a maximum of 2 months. During maintenance therapy, IFN-α2b was scheduled for 3 MU 3 times weekly for 2 months and subsequently 3 MU 2 times weekly for 10 months and PUVA was gradually reduced every 2 months over a period of 12 months. Diagnostic, risk and response assignments were according to EORTC criteria. Results: Patient characteristics at time diagnosis, staging, response rates and overall outcome are shown in Table 1. Among the 87 patients, overall response rate (ORR) was 97.8% (n=85) and included complete remission (CR) in 70 patients (80.5%), very good partial remission in 5 patients (5.8%) and partial remission (PR) in another 10 (11.5%). The best response to therapy was seen after a median of 5 months (range, 1-30) and the 74.3% of patients who achieved a CR after induction therapy kept the complete response at the last follow up. Among the responders, 40 (47.1%) relapsed with minor event with in median time of 21 months (range, 0-71) and 7(8.2%) relapsed with major event in a median time of 6 months (range, 1-81). After a median follow up of 207 months (range, 6-295), 25 (28.7) patients died, only 1 for progressive disease. Median overall survival (OS) for our cohort was not reached (95% CI; 235-NR months) and median time to next treatment (TTNT) was 38.5 months (95% CI, 33-46 months). Moreover, disease free survival (DFS) in CR patients was 210 months (95% CI; 200-226 months). Conclusions: The long follow up of this study verifies our preliminary results and confirms the efficacy of INF-PUVA combination therapy in a real world setting, according conventional (OS and DFS) and emerging (TTNT) clinical endpoints of treatment efficacy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Tazarotene 0.1% Cream as Monotherapy for Early-Stage Cutaneous T-Cell Lymphoma

2016 ◽  
Vol 20 (3) ◽  
pp. 244-248 ◽  
Author(s):  
Catherine Besner Morin ◽  
David Roberge ◽  
Irina Turchin ◽  
Tina Petrogiannis-Haliotis ◽  
Gizelle Popradi ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Lymphoma ◽  
Early Stage ◽  
Complete Response ◽  
T Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Open Label ◽  
Topical Retinoids ◽  
Few Data ◽  
Mean Time

Background: Numerous treatments are available for cutaneous T-cell lymphoma (CTCL), including systemic retinoids. Very few data are available on topical retinoids. Objectives: The aim of this study was to evaluate the safety and efficiency of tazarotene as monotherapy for early-stage CTCL. Methods: An open-label, prospective study of tazarotene as monotherapy for stages IA to IIA CTCL was conducted. Index lesions on 10 patients were followed for 6 months on treatment, plus at least 6 months off treatment. Results: Six patients (60%) showed complete response (CR). Erythema, scaling, thickness, and lesion area decreased progressively throughout treatment. The mean time to CR was 3.8 months; CR was durable for at least 6 months in 83%. Of the 4 patients (40%) without CR, 2 (20%) had stable disease and 2 (20%) stopped the medication because of local side effects; none showed progression. Conclusions: This is the first Canadian trial providing evidence that topical tazarotene has excellent potential as a monotherapy agent for stages I to IIA CTCL.

Late Relapses Characterize Autologous Transplantation (ASCT) in First Complete Remission (CR) for Peripheral T-Cell Lymphoma (PTCL).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5110-5110 ◽  
Author(s):  
Tarun Kewalramani ◽  
Steve Horwitz ◽  
Andrew D. Zelenetz ◽  
Stephen D. Nimer ◽  
Craig H. Moskowitz
Keyword(s):  
T Cell ◽  
Median Time ◽  
Progressive Disease ◽  
Cell Lymphoma ◽  
Autologous Transplantation ◽  
Conditioning Regimen ◽  
Allogeneic Transplantation ◽  
T Cell Lymphoma ◽  
Time To Progression

With the exception of ALK-positive anaplastic large cell lymphoma (ALCL), standard-dose chemotherapy is curative in a minority of patients (pts) with PTCL, and most pts have progressive disease less than 2 years from completing treatment. Several studies suggest that ASCT in 1st CR significantly improves the short-term outcome of pts with PTCL, but its long-term efficacy is not known. To address this, we assessed the outcome of sequential patients who underwent ASCT in 1st CR (n=15). Histologic subtypes were PTCL, unspecified, in 6 pts, angioimmunoblastic T-cell lymphoma in 5 pts, ALK-negative ALCL in 3 pts and hepatosplenic gamma delta T-cell lymphoma in 1 pt. Induction chemotherapy was CHOP (n=2) or CHOP-ICE hybrid (n=12) in 93% of pts. The age-adjusted IPI (AAIPI) was 2–3 in 9 of 14 assessable patients (64%), and 11 pts (73%) had stage III–IV disease. The conditioning regimen consisted of BEAM or CBV in 10 pts and TBI/Cy/VP-16 in 5 pts. All patients received peripheral blood progenitor cells for hematopoietic support. The median follow-up of all patients is 24 months (range 4.5–70). Five pts (33%) have progressed, with a median time to progression of 50 months (range 10–70). Four of the 5 pts who progressed did so more than 2 years from ASCT; they comprise 57% of patients with more than 2-years of follow-up. Four of 5 patients with progressive disease have died, with a median time from progression to death of 1 month (0.6–14.6). In this small series the AAIPI was not predictive of PFS or OS. While our results confirm the that ASCT in 1st CR significantly delays the time to progression, they suggest that it may not be curative in the majority of patients. If confirmed in ongoing larger prospective studies, this observation warrants trials of post-ASCT maintenance treatment and, for younger patients, trials of allogeneic transplantation in 1st CR or sequential ASCT followed by allogeneic transplantation. Figure Figure

The use of single-fraction radiation therapy in cutaneous T-cell lymphoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19505-e19505
Author(s):  
A. M. Babbo ◽  
M. Chokshi ◽  
A. Rademaker ◽  
B. Mittal
Keyword(s):  
Radiation Therapy ◽  
T Cell ◽  
Cell Lymphoma ◽  
The United States ◽  
T Cell Lymphoma ◽  
Response To Treatment ◽  
Cutaneous T Cell Lymphoma ◽  
Single Fraction ◽  
Cutaneous Lymphomas

e19505 Background: Primary cutaneous lymphomas occur in 0.5 to 1 per 100,000 people every year in developed countries. Less than 1,000 cases of Mycosis Fungoides are diagnosed each year in the United States, with approximately 3 cases per 1,000,000 per year. Cutaneous T-cell lymphomas are responsive to radiation therapy, and local radiation therapy, total skin electron beam therapy, phototherapy (with UVB or PUVA), chemotherapy agents (nitrogen mustards, BCNU), retinoids, and steroids have all been used with varying degrees of success. Methods: This is a retrospective review of all cases of histology-proven cutaneous T-cell lymphoma treated with single-fraction radiation therapy at Northwestern Memorial Hospital in the Department of Radiation Oncology since 1990. We looked at response to treatment and local control. We reviewed the charts of 67 patients with cutaneous T-cell lymphoma, of which 40 patients and a total of 130 sites of disease received single-fraction radiation therapy and had available follow-up data. Results: Of the 130 lesions receiving a single-fraction of radiation, 86 (66%) received 800cGy in 1 fraction and 38 (29%) received 700cGy. 4 patients (3%) received 750cGy, 1 (<1%) received 550cGy and 1 (<1%) received 500cGy. Patients were treated with electron energies ranging from 6–18 MeV or photon energies ranging from 4–10 MV. Out of 130 lesions, 119 (92%) achieved a complete response (CR) to single-fraction radiation and 11 (8%) achieved a partial response (PR). There were 2 sites of relapse out of 130 treated sites, involving 2 patients. The median follow-up time was 4 months, mean follow-up time was 14 months, and 44% of patients had greater than 6 months of follow-up. Conclusions: This review of the experience at our institution since 1990 shows single-fraction radiation therapy to be an effective treatment for cutaneous T-cell lymphoma, with high response rates and very low relapse rates. No significant financial relationships to disclose.

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