Evaluation and management of patients with early-stage mycosis fungoides who interrupt or discontinue topical mechlorethamine gel because of dermatitis

Chlormethine Gel in Combination with Other Therapies in the Treatment of Patients with Mycosis Fungoides Cutaneous T Cell Lymphoma: Three Case Reports

“…While skin-related AEs were experienced by each patient after the initiation of CL gel treatment, they could be effectively managed by adding topical emollients, steroids, or reducing the CL gel dose. This is in line with published data [ 11 ]. Appropriate management of these AEs is critical for optimal disease management.…”

“…Many patients who experience mild-to-moderate hypersensitivity reactions after initiation of CL gel can continue treatment after intervention. Even patients who have severe skin reactions can restart treatment at lower frequencies to test tolerance and may be able to continue treatment [ 11 ]. Moreover, there is evidence to suggest that the development of cutaneous reactions, such as contact dermatitis, does not impact the response to CL gel [ 11 , 26 ] and in some instances has led to earlier clearance of the lesion(s) [ 27 ].…”

“…It is stable, nongreasy, and quick drying, and these properties allow it to be conveniently administered at home, which may encourage treatment compliance. While cutaneous reactions such as contact dermatitis may be seen following CL gel treatment, these can be effectively managed through treatment adjustments and the use of emollients or corticosteroids, depending on the patient's needs [ 11 ].…”

Increased Chlormethine-Induced DNA Double-Stranded Breaks in Malignant T Cells from Mycosis Fungoides Skin Lesions

“…(Goodman et al, 1984) The topical use of CL has been a well-established and effective primary therapy for the management of lymphoid malignancies, including MF, since the 1950s. (Gilmore et al, 2020, Kim, 2003, Lessin et al, 2013 A 0•016% CL gel formulation was purposely developed to treat MF, and in 2013 was approved by the U.S. Food and Drug Administration for the topical treatment of stage IA and IB MF in patients who received prior skin-directed therapy, (Helsinn Birex Pharmaceuticals Ltd, 2013, Talpur et al, 2014 based on results of a phase II trial. (Lessin et al, 2013, Talpur et al, 2014, Trautinger et al, 2017 Additionally, CL gel has been registered in Israel since 2016 in the same US indication, (Denis et al, 2019) and was approved by the European Medicines Agency in 2017…”

A Little Experience Goes a Long Way: Chlormethine/Mechlorethamine Treatment Duration as a Function of Clinician-Level Patient Volume for Mycosis Fungoides Cutaneous T-Cell Lymphoma (MF-CTCL)—A Retrospective Cohort Study

“…Chlormethine gel yields high response rates, particularly with treatment >3 months (1,2). Early discontinuation is often attributed to skin reactions (1,3). Treatment discontinuation as a result of non-compliance has previously been observed with ointment-based topical treatments such as chlormethine ointment or certain corticosteroids, mainly due to greasiness, but this appears to be less common with chlormethine gel (1,2,4,5).…”