Low-dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients

Zackheim, Herschel S.; Kashani‐Sabet, Mohammed; McMillan, Alex

doi:10.1016/s0190-9622(03)01591-3

Cited by 126 publications

(79 citation statements)

References 15 publications

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“…58 In this study, the median weekly dose was 25 mg with maximum doses up to 75 mg. Low-dose MTX has been successfully combined with IFN-␣. 60 …”

Section: Low-dose Mtxmentioning

confidence: 90%

“…There are few published reports on the use of MTX in MF, 58,59 with the largest series of 60 patients with patch/plaque MF (T2) achieving a 12% CR and 22% PR rate with a median time to treatment failure of 15 months. 58 In this study, the median weekly dose was 25 mg with maximum doses up to 75 mg. Low-dose MTX has been successfully combined with IFN-␣.…”

Section: Low-dose Mtxmentioning

confidence: 99%

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How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

136

109

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The most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.

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“…58 In this study, the median weekly dose was 25 mg with maximum doses up to 75 mg. Low-dose MTX has been successfully combined with IFN-␣. 60 …”

Section: Low-dose Mtxmentioning

confidence: 90%

Section: Low-dose Mtxmentioning

confidence: 99%

How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

136

109

View full text Add to dashboard Cite

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“…There are few published reports on the use of MTX in MF, even though initial reports appeared more than a quarter of a century ago. 106 McDonald and Bertino administered high-dose intravenous MTX to 11 patients with stage II-III MF. 107 Seven patients achieved a CR, which was maintained with weekly low-dose intravenous MTX.…”

Section: Denileukin Diftitoxmentioning

confidence: 99%

“…108 In the study by Zackheim and colleagues described above the medium weekly dose was 25 mg with maximum doses up to 75 mg; side-effects were responsible for treatment failure in 6 (9%) of the total cohort of 69 patients. 106 12.2.2. Systemic therapies combined with SDT 12.2.2.1.…”

Section: Denileukin Diftitoxmentioning

confidence: 99%

EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome

Trautinger

Knobler

Willemze

et al. 2006

European Journal of Cancer

391

308

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“…For example, overall response rates of 58-76% (and 41% complete response rate) have been observed in patients with MF/SS treated with low-dose, oral methotrexate [336][337][338][339]. In contrast, for patients with an adequate performance status, single-agent gemcitabine [340][341][342][343][344], pegylated liposomal doxorubicin [345][346][347][348] and pentostatin [349][350][351][352][353][354][355] are frequently utilized (Table VI).…”

Section: Systemic Chemotherapymentioning

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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Low-dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients

Cited by 126 publications

References 15 publications

How I treat mycosis fungoides and Sézary syndrome

How I treat mycosis fungoides and Sézary syndrome

EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome

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

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