0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Systemic Therapy of Cutaneous T-Cell Lymphomas (Mycosis Fungoides and the Sezary Syndrome)

Paul A. Bunn, MD; Stephen J. Hoffman, MD; David Norris, MD; Loren E. Golitz, MD; and John L. Aeling, MD
[+] Article and Author Information

From the University of Colorado Cancer Center and Health Sciences Center, Denver, Colorado. Requests for Reprints: Paul A. Bunn, Jr., MD, University of Colorado Cancer Center, 4200 East Ninth Avenue, Campus Box B-188, Denver, CO 80262. Acknowledgments: The authors thank Sandra Stricker for editorial assistance and Robin Hohsfield, RN, for data management support. Grant Support: In part by National Institutes of Health grants 1 P50 CA58187-01 and 1 P30 CA46934-06.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;121(8):592-602. doi:10.7326/0003-4819-121-8-199410150-00007
Text Size: A A A

Objective: To review recent studies of systemic therapy for mycosis fungoides and the Sezary syndrome (cutaneous T-cell lymphomas).

Data Sources: English-language articles indexed in MEDLINE from 1988 through 1994.

Study Selection: All therapeutic studies were selected.

Data Extraction: The data were abstracted without judgments on response criteria or patient numbers. Data quality and validity were assessed by independent author reviews.

Data Synthesis: No systemic therapy cures patients with cutaneous T-cell lymphomas. Single and combined chemotherapeutic agents produce high response rates. Whether any of these is preferred is not established. A randomized trial comparing combination chemotherapy plus radiation therapy with topical therapy showed no survival benefit for the combination. Several adenosine analogs and retinoids were active, but their optimal use is uncertain. Interferons are as active as chemotherapeutic agents and may be less toxic. Interferon combined with psoralen plus ultraviolet A light therapy produces high complete response rates and long-lasting remissions. Combinations with other systemic therapies do not increase response rates. Photopheresis therapy should be regarded as experimental. Promising preliminary results were seen with interleukin-2 fusion toxins and several antibody conjugates.

Conclusions: Systemic therapy should be considered effective and palliative. The principles of treating all low-grade lymphomas can be applied. Randomized trials are needed to evaluate new agents (such as a comparison of psoralen plus ultraviolet light with or without interferon), and large phase II trials are needed for new agents such as photopheresis, interleukin-2 fusion toxin, temozolomide, and others.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)