Treatment of Cutaneous T‐cell Lymphomas (CTCL) with Extracorporeal Photochemotherapy

Abstract

Since August of 1988, we have treated seven CTCL patients with extracorporeal photochemotherapy, including two with tumor-stage mycosis fungoides (MF) showing mucinous degeneration, two with plaque-stage MF, and two with erythrodermatous MF. One was withdrawn just after the first trial. For each patient, the phenotypes of peripheral blood lymphocytes were analyzed by flow cytometry in terms of the percentages of OKT11, OKT3, OKT4, Leu9, OKT8, B1, Tac, OKT9, OKIa1, Leu7, Leu3a/4B4, and Leu3a/2H4 cells. These parameters were compared with the clinical responses according to skin score. The two patients with tumors died, but the five patients without tumors did not. Three of the 6 patients responded to the treatment. Side effects that are often associated with standard chemotherapy, such as bone marrow suppression, gastrointestinal symptoms and hair loss, were not observed. One cardiovascular event (1 patient) occurred. No significant changes in T-cell subsets were seen during the course of therapy. These preliminary data suggest that extracorporeal photochemotherapy may be effective for CTCL other than tumor-stage MF.

Effects of Extracorporeal Photopheresis on Quality of Life and the Course of Diseases in Patients With Mycosis Fungoides and Graft-Versus-Host Disease: A Single-Center Analysis

“…The results of our study have shown that the median Skindex-29 score was decreased by 42% (from 88 to 51), after the application of ECP. A corresponding improvement between 40-50% has also been recorded by other retrospective studies [19][20][21][22][23][24][25]. The observed improvement in the Skindex-29 score mainly results from the improvement of the symptoms (questions 3, 10, 19, 28) and less from the improvement of the patients' functionality (questions 2, 29).…”

The Role of UV Irradiation in the Prevention of HLA Alloimmunization and in Therapeutic Apheresis.

“…Other studies have been published since the initial report, with similar results: responses greater than 75% was observed in 5 out of 32 patients (Heald, 1989), 1 out of 8 patients (Armus, 1990), and in 2 out of 7 patients in the latest published report (Nagatani, 1990).…”