Treatment of stage Ia and Ib mycosis fungoides with psoralen UVA monotherapy: an observational study in tertiary hospitals in the Canary Islands

Abstract

Psoralen with UVA is a safe and effective treatment for early-stage MF. Patch disease responds more favorably than plaque disease and is associated with a longer period of DFS. Maintenance treatment does not appear to reduce recurrence. Current evidence suggests that the proposed revision to the classification of MF, which takes into account the extent and type of disease, more accurately predicts response to PUVA.

Standardization of regimens in Narrowband UVB and PUVA in early stage mycosis fungoides: position paper from the Italian Task Force for Cutaneous Lymphomas

“…Unfortunately, PUVA is linked with increased incidence of non‐melanoma skin cancers in psoriatic patients in a dose‐dependent manner, especially when cumulative dose reaches 2000 J or over 200 applications have been performed . Moreover, as we recently evaluated in a Critical Appraisal Topic, only three single centre studies published in literature have directly compared relapse rates and RFI between patients who received maintenance phase and those who underwent follow‐up. None of these studies has shown a significant difference in both RR and RFI, and more important, the evidence is based only on small cohorts without randomization.…”

Maintenance phase in psoralen-ultraviolet A phototherapy of early-stage mycosis fungoides. A critically appraised topic

“…Taking into account all data analysed in this CAT, we conclude that there is inadequate evidence to support the routine introduction of a maintenance phase in the PUVA treatment regimen for early‐stage MF. In fact, in all three relevant studies, although nonrandomized and controlled, there was no evidence of a benefit from a maintenance regimen both in terms of relapse reduction and RFI or disease‐free survival in comparison with simple follow‐up . The results from the studies do not allow us to evaluate if very prolonged maintenance schedules may effectively prolong RFI, as has been proposed in a retrospective study .…”

“…Lastly, we excluded all studies without a direct comparison between patients who underwent maintenance regimens after CR and those who received no further therapies (5). At the end of this accurate analysis, three works were selected for critical appraisal . We did not find any new relevant articles by a manual search of related articles.…”

“…Hernández et al . analysed retrospectively all patients with early‐stage MF who underwent PUVA phototherapy in their institution from 1999 to 2010.…”

“…Lastly, this kind of study protocol does not allow evaluation of whether longer maintenance or continuing maintenance therapy indefinitely until relapse might allow a prolonged RFI, as suggested from the results of a retrospective single‐centre study . In the retrospective study by Hernández et al . maintenance therapy seemed not to be able to significantly reduce the RR.…”