Total Skin Electron Beam and Non-Myeloablative Allogeneic Hematopoietic Stem-Cell Transplantation in Advanced Mycosis Fungoides and Sézary Syndrome

Abstract

Total skin electron beam followed by allogeneic stem-cell transplantation merits additional evaluation for a selected group of patients with refractory, advanced, cutaneous T-cell lymphoma with evidence for graft-versus-tumor effect.

Allogeneic stem cell transplantation for advanced cutaneous T-cell lymphomas: a study from the French Society of Bone Marrow Transplantation and French Study Group on Cutaneous Lymphomas

“…Primary cutaneous CD30-positive anaplastic large cell lymphoma is a less frequent subtype of primary cutaneous T-cell lymphoma that, in its disseminated form, shares an aggressive clinical course. 7 Allogeneic HSCT has been reported in advanced mycosis fungoides and Sézary syndrome in retrospective cases or case series, [8][9][10][11][12][13] the 2 largest including 19 10 and 60 11 patients. Allogeneic HSCT for transformed mycosis fungoides has only been reported in case reports (n=11).…”

“…Allogeneic HSCT for transformed mycosis fungoides has only been reported in case reports (n=11). [8][9][10]13,14 Even less is known regarding allogeneic HSCT in other less frequent subtypes of advanced primary cutaneous T-cell lymphomas (γδ cutaneous T-cell lymphoma, n=3; 13,15 subcutaneous panniculitic T-cell lymphoma, n=2; 16,17 CD30-negative primary cutaneous T-cell lymphoma, n=1;…”

Phase 1/2 study of mogamulizumab, a defucosylated anti-CCR4 antibody, in previously treated patients with cutaneous T-cell lymphoma

“…Median patient age was 66 years (range, 35-85). The median number of prior systemic treatments for lymphoma was 3 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The majority of patients (59.5%) had also received prior radiation therapy, which included psoralen plus ultraviolet A (n 5 13), electron beam (n 5 13), ultraviolet B (n 5 8), and external beam (n 5 3) therapy.…”

“…[3][4][5][6] The pathogenesis of CTCLs is not fully understood, but an alteration in the skin-homing and/or skin-resident T cells, lack of normal cellular differentiation, and apoptosis of T cells are common. Other than allogeneic hematopoietic stem cell transplantation, 7 no treatment has been shown to be curative and advanced disease can become refractory, leading to serious clinical complications. Thus, newer therapies for CTCL are needed, especially targeted therapies focused on malignant T cells.…”

Trends in the treatment of cutaneous T-cell lymphoma – critical evaluation and perspectives on vorinostat

“…This therapy should be followed by long-term maintenance therapy, such as mustargen, phototherapy, oral bexarotene, or if the patient is young and healthy, an allogeneic stem cell transplant. 16 Patients with advanced CTCL may respond to localized radiation, denileukin diftitox, or histone deacetylase (HDAC) inhibitors (HDAC-Is). 17 Chemotherapies, including nucleoside analogues (gemcitabine, pentostatin) or pegylated liposomal doxorubicin, are reserved for patients with refractory tumors or nodal disease.…”