Photodynamic Therapy with Methyl-aminolaevulinic Acid for Mycosis Fungoides

Abstract

Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. There are a wide range of treatments for early-stage and advanced-stage mycosis fungoides. Photodynamic therapy (PDT) has emerged as a new treatment modality due to its safety and efficacy. The aim of this study was to investigate the safety and efficacy of PDT with methyl-aminolaevulinic acid (MAL) for the treatment of mycosis fungoides. Ten patients with mycosis fungoides were enrolled in this study. A 16.8% MAL cream was applied under occlusive dressing for 3 h. The lesion was irradiated at 37.5 J/cm2 with red light. The patients underwent two sessions of PDT at one-week intervals. Follow-up biopsy was performed 3 months after the last treatment. In case of partial response, treatment was repeated once a week until complete response. Seven patients had a good therapeutic response. Complete and partial responses were seen in 5 and 2 patients, respectively. During the follow-up period (8-31 months), 6 of the 7 patients remained in stable remission. The treatment was well-tolerated overall, and no patients discontinued the PDT due to pain. In conclusion, PDT with MAL is a fast, effective and well-tolerated treatment for unilesional mycosis fungoides.

Photodynamic therapy with methyl-aminolevulinic acid for paucilesional mycosis fungoides: A prospective open study and review of the literature

“…Pain during MAL-PDT sessions has been assessed in 3 previous studies concerning patients with MF. 7,9 The mean levels of pain, rated using an analog scale, were 3.6, 9 4.8, 12 and 3 7 and similar to levels observed in our study (mean 4.1). Pain is often higher when PDT is used in other indications.…”

“…[7][8][9][10][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In total, 68 patients with MF have been treated with PDT in the literature. The first cases were reported in 1994 25,26 and until 2006, the 5-aminolevulinic acid photosensitizer was used.…”

“…[4][5][6] There are a few publications reporting the efficacy of photodynamic therapy (PDT) in MF, however they involve small samples and are difficult to compare because of a lack of technical standardization. [7][8][9][10] In total, 68 patients with MF treated with PDT have been reported. Two different photosensitizers have been used: 5-aminolevulinic acid and the methylaminolevulinic acid (MAL), and the number of PDT sessions, time interval between 2 sessions, duration of the occlusive photosensitizer application, and illumination duration can be highly variable.…”

Chlorin e6 Conjugated Interleukin-6 Receptor Aptamers Selectively Kill Target Cells Upon Irradiation

“…IL-6R–related diseases like mycosis fungoides, castleman's disease, as well as inflammatory disorders such as rheumatoid arthritis and other cutaneous diseases are currently of interest for PDT and their treatment might be improved by further development of aptamer conjugates in the future. 41,42,43 …”

Unilesional plantar mycosis fungoides treated with topical photodynamic therapy – case report and review of the literature

“…A total of 13 papers were identified, which appeared under the search criteria named above (see Table 1 [5][6][7][8][9][10][11][12][13][14][15][16]19 The following parameters were selected from the papers: number of patients, age of the patient, sex of the patient, location of lesion, type of photosensitizer, number of PDT sessions, type of PDT device, outcome (CR: complete remission, PR: partial remission, SD: stable disease, PD: progressive disease) and follow-up (in months).…”