Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: A 10-year experience at a single institution

Gottlieb, Scott; Wolfe, Jonathan; Fox, Floyd E.; DeNardo, Barbara J.; Macey, William H.; Bromley, Patricia; Lessin, Stuart R.; Rook, Alain H.

doi:10.1016/s0190-9622(96)90119-x

Cited by 200 publications

(189 citation statements)

References 30 publications

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“…Furthermore, Gottlieb and colleagues, reported a CR rate of 25% and a PR rate of 46% from a retrospective chart review of 28 patients with stage III or IV disease. 127 The majority of these patients also had circulating malignant T cells. In a retrospective analysis of data from 23 patients with SS, Evans and colleagues observed an ORR of 57%.…”

Section: Chemotherapy Many Different Chemotherapeuticmentioning

confidence: 99%

“…77 Suchin and colleagues observed a 75% ORR in a retrospective cohort study, and Gottlieb and colleagues reported a CR rate of 25% and a PR rate of 46% from a retrospective chart review of 28 patients with stage III or IV disease. 126,127 In addition, ECP has minimal side-effects. 77,128 Zic and colleagues also reported a CR rate of 25% and PR rate of 25% in a cohort of 20 patients.…”

Section: Retinoids Plus Puva Thomsen and Colleagues Re-mentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Chemotherapy Many Different Chemotherapeuticmentioning

confidence: 99%

Section: Retinoids Plus Puva Thomsen and Colleagues Re-mentioning

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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“…It is not surprising then that the median time to response following the initiation of ECP is 6 months. Median survival exceeding 8 years has been observed in ECP treated patients and among complete responders, many experience durable responses which may permit, for some, weaning from CTCL-directed therapies [310,[312][313][314]. While patient-or disease-specific factors which may predict a response to therapy are imperfect, patients for whom treatment is initiated promptly after diagnosis who have circulating Sé zary cells, but without significant nodal or visceral disease, may be more likely to respond.…”

Section: Extracorporeal Photophoresismentioning

confidence: 99%

“…In addition, patients without profound immune deficiencies, reflected by normal or near-normal cytotoxic T-cell and CD4/CD8 values and the absence of prior exposure to systemic chemotherapy, may be more likely to respond to therapy [310,313]. While effective as monotherapy, ECP has also been combined with other therapeutic strategies, including interferon, bexarotene and TSEBT [292,302,312,[315][316][317].…”

Section: Extracorporeal Photophoresismentioning

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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“…6,24 In this disease, photopheresis induces longterm clinical responses and possibly enhanced survival rates. [25][26][27][28] Accumulating evidence suggests that the therapeutic effect of photopheresis in CTCL is dependent on the presence of circulating clonally amplified T cells, and due to the induction of an immune response against defined lymphocyte populations that are central to its pathogenesis (for review see Ref. 6).…”

Section: Bone Marrow Transplantationmentioning

confidence: 99%

Identification of amplified clonal T cell populations in the blood of patients with chronic graft-versus-host disease: positive correlation with response to photopheresis

French

Alcindor

Shapiro

et al. 2002

Bone Marrow Transplant

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Summary:Chronic graft-versus-host disease (cGVHD) is a multiorgan disorder with skin manifestations resembling scleroderma. Since photopheresis, a treatment that induces an anticlonotypic immune response, has proven to be effective in both cutaneous T cell lymphomas with circulating clonal T cells and in cGVHD, we have searched for circulating clonal T cell populations in patients with cGVHD, and determined whether T cell clonality in the blood is associated with therapeutic response. We screened blood samples from 27 patients after HLA-matched allogeneic bone marrow transplantation (allo-BMT), 10 without cGVHD and 17 with extensive cGVHD, for clonal T cell receptor ␥ (TCR␥) gene rearrangements using fluorescent-based polymerase chain reaction (PCR) and automated high-resolution capillary electrophoresis. Amplified populations of clonal T cells with unique TCR␥ gene rearrangements were found in six of 10 (60%) allo-BMT patients without cGVHD and 13 of 17 (76.5%) allo-BMT patients with cGVHD (P = 0.41), as compared to none of 10 (0%) healthy controls. Twelve patients with cGVHD were treated by photopheresis, and the presence of amplified populations of clonal T cells was found to be associated with a cutaneous response to photopheresis, as eight of eight (100%) clone-positive vs none of four (0%) clonenegative patients experienced a clinically significant cutaneous response to treatment (P = 0.001). Our findings suggest that patients with cGVHD that have detectable expanded clonal T cell populations in their peripheral blood, may be more likely to respond to treatment by photopheresis.

show abstract

Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and in combination with recombinant interferon alfa: A 10-year experience at a single institution

Cited by 200 publications

References 30 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

Identification of amplified clonal T cell populations in the blood of patients with chronic graft-versus-host disease: positive correlation with response to photopheresis

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