Topical carmustine (BCNU) for cutaneous T cell lymphoma: A 15-year experience in 143 patients

Zackheim, Herschel S.; Epstein, Ervin; Crain, William R.

doi:10.1016/0190-9622(90)70112-u

Cited by 141 publications

(55 citation statements)

References 17 publications

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“…Zackheim and colleagues retrospectively reported the results of 143 patients treated over a 15-year period. 92 A CR rate of 86% was achieved in patients with T1 disease, and a 48% CR rate was seen in those with T2 disease. In a subsequent report, the same group noted that, at 36 months following initiation of treatment in 172 patients, 92% of patients with stage I and 64% with stage II disease were in CR or PR.…”

Section: Topical Bcnumentioning

confidence: 89%

“…[92][93][94] No randomised controlled trials have been reported. Zackheim and colleagues retrospectively reported the results of 143 patients treated over a 15-year period.…”

Section: Topical Bcnumentioning

confidence: 99%

“…93 Zackheim and colleagues, in their series of 143 patients, reported that mild haematopoietic depression occurred in less than 10% of patients. 92 However, others have reported bone marrow suppression rates of 30%. 30 The most common side-effect was an erythematous reaction, although no secondary cutaneous malignancies occurred.…”

Section: Topical Bcnumentioning

confidence: 99%

“…30 The most common side-effect was an erythematous reaction, although no secondary cutaneous malignancies occurred. 92,93 Gastrointestinal toxicity has been frequently noted, usually within 2 h of BCNU administration, and renal dysfunction has been reported in patients exposed to large cumulative doses. 95 96 The combination therapy achieved a significantly higher CR rate but at the expense of considerable toxicity.…”

Section: Topical Bcnumentioning

confidence: 99%

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

Trautinger

Knobler

Willemze

et al. 2006

European Journal of Cancer

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308

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Section: Topical Bcnumentioning

confidence: 89%

“…[92][93][94] No randomised controlled trials have been reported. Zackheim and colleagues retrospectively reported the results of 143 patients treated over a 15-year period.…”

Section: Topical Bcnumentioning

confidence: 99%

Section: Topical Bcnumentioning

confidence: 99%

Section: Topical Bcnumentioning

confidence: 99%

See 2 more Smart Citations

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

Trautinger

Knobler

Willemze

et al. 2006

European Journal of Cancer

391

308

View full text Add to dashboard Cite

“…Topical BCNU (carmustine) is associated with complete remission rates exceeding 80% following a median of 3 months of therapy. Because of systemic absorption, it is associated with myelosuppression which requires monitoring, and in some cases dose modifications [209,210]. The most common toxicities are benign cutaneous reactions, including erythema, telangiectasias and hyperpigmentation.…”

Section: Treatment Of Limited-stage Mfmentioning

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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Topical Corticosteroids for Mycosis Fungoides

Zackheim¹,

Kashani‐Sabet²,

Amin³

1998

Arch Dermatol

Self Cite

213

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Setting: Academic referral center, Veterans Affairs Medical Center, and private practice.Patients: Seventy-nine patients with patch or plaque stage of mycosis fungoides. Fifty-one were stage T1 (less than 10% of skin involved) and 28 were stage T2 (10% or more of skin involved). Seventy-five had patch-stage and 4 had plaque-stage disease as determined by histological examination. Intervention: Patients were treated with topical class I to III corticosteroids. Of the stage T1 patients, all used class I corticosteroids, and 4 (8%) also used class II or III corticosteroids. Of the stage T2 patients, 19 (68%) used class I and 12 (43%) used class II or III compounds. Some patients used more than 1 class of corticosteroid. Applications were almost always twice daily. Three stage T1 and 2 stage T2 patients used plastic film occlusion. Baseline and monthly morning serum cortisol levels were obtained during treatment. Main Outcome Measures: Response to treatment and side effects.Results: The median follow-up period was 9 months. Thirty-two (63%) of stage T1 patients achieved complete remission and 16 (31%) achieved partial remission, for a total response rate of 48 (94%). The comparable figures for stage T2 patients were 7 (25%), 16 (57%), and 23 (82%), respectively. Responses were determined by clinical examination. Thirty-nine patients achieved clinical clearing. In 7 of these, posttreatment biopsy speciments were obtained, and all showed histological clearing. Reversible depression of serum cortisol levels occurred in 10 (13%). Minor skin irritation occurred in 2 patients and localized, reversible skin atrophy in 1. Conclusion:Topical corticosteroids, especially class I compounds, are an effective treatment for patch-stage mycosis fungoides.

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Topical carmustine (BCNU) for cutaneous T cell lymphoma: A 15-year experience in 143 patients

Cited by 141 publications

References 17 publications

EORTC consensus recommendations for the treatment of mycosis fungoides/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

Topical Corticosteroids for Mycosis Fungoides

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