Valchlor maintenance therapy for patients with mycosis fungoides who received low dose total skin electron beam treatment

Jennings, Tara; Duffy, Robert; Gochoco, Ashley; Knoblauch, Kelly; Shi, Wenyin; Alpdogan, Seyfettin Onder; Porcu, Pierluigi; Werner‐Wasik, Maria; Sahu, Joya

doi:10.21037/cco.2018.10.01

Cited by 20 publications

(29 citation statements)

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“…For late stage, the dermatology‐specific and generic QoL was more severely affected and more intense pruritis were found. In the studies describing mixed stage disease, the pruritis scores seemed higher in the studies that described a lower QoL 17,20,21,27,28 . Steinke et al.…”

Section: Resultsmentioning

confidence: 98%

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Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature

Ottevanger

Beugen

Evers

et al. 2021

Acad Dermatol Venereol

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Cutaneous T‐cell Lymphoma’s (CTCL) are a rare, heterogeneous group of T‐cell lymphomas that primarily manifest in the skin. Mycosis fungoides (MF) and Sézary syndrome (SS) are considered the classic types of CTCL. The diverse manifestation of CTCL results in a wide range of symptoms with a possible mild to severe impact on Quality of Life (QoL) depending on the disease stage. Previous studies on QoL in CTCL patients report diverse patient populations and use many different QoL instruments. In the current literature, a clear overview on the influence of the different stages of disease (early MF, late‐stage MF/SS or total group) on the QoL is lacking. Therefore, a systematic search of the literature was conducted using the PubMed, Embase, PsycINFO and Web of Science databases. Studies were included if they described QoL in patients with MF and SS retrieved by standardized instruments or qualitative interviews. In total, 24 studies were included using 18 different questionnaires to report on dermatology‐specific, cancer‐specific and generic QoL. The effect on QoL was found to be greater in patients with late‐stage disease as compared to early stage disease, with significant impairments on functional, emotional and physical domains. Nonetheless, even in patients with limited disease, QoL was mildly to moderately affected. Overall, pruritus was the most frequent reported and most bothersome symptom. Significant influence of the disease on daily life activities were found, not only in patients but also on caregivers and family. This broad, structured overview on QoL in MF and SS patients underlines the influence of disease stage on QoL, and therefore, recommends future studies to distinguish between disease stages when reporting results. Furthermore, this overview can inform clinicians in clinical practice by creating awareness of QoL deficits according to disease stage.

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Section: Resultsmentioning

confidence: 98%

“…Details of the selection process for eligible studies are shown in Figure 1. In total, 24 studies matched the eligibility criteria 5,6,11–32 . All included studies were published between 2001 and 2020.…”

Section: Resultsmentioning

confidence: 99%

Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature

Ottevanger

Beugen

Evers

et al. 2021

Acad Dermatol Venereol

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“…Recent studies indicate that maintenance therapy after TSEBT may improve the PFS (Elsayad et al 2020b;Heumann et al 2015;Jennings et al 2019). Low-dose focal radiotherapy combined with romidepsin therapy seems to be safe and reasonable option in patients with symptomatic lesions (Akilov et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Acute and sub-acute toxicity profile of ultra-hypofractionated low-dose total skin electron beam with two 4 Gy fractions for cutaneous T cell lymphoma

Rolf

Elsayad

Eich

2020

J Cancer Res Clin Oncol

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Purpose Low-dose total skin electron beam therapy (TSEBT) over 3 weeks has proved to be a safe and effective treatment for cutaneous T cell lymphomas (CTCL). In this prospective trial, we examined the feasibility of ultra-hypofractionated low-dose TSEBT regimen in two fractions with 4 Gy combined with systemic therapy to minimize the number of visits to radiation centers. Patients and methods Six patients with mycosis fungoides (MF) or Sézary syndrome (SS) received TSEBT with a total radiation dose of 8 Gy in two fractions between April 2020 and June 2020. Patient and treatment characteristics, tumor burden, the impact on the quality of life using Skindex-29 questionnaires, and acute toxicities were analyzed. Results During TSEBT, all patients developed grade 1 toxicities while two patients developed grade 2 toxicities. One patient experienced sepsis. The most common adverse effects were erythema and edema. All grade 2 toxicities regressed after 4 weeks following TSEBT. Based on the reported symptoms measured by Skindex-29, we detected a significant reduction in total Skindex-29 score after 8 weeks of radiation (P = 0.03), particularly in the symptoms (P = 0.01) and emotional domains (P = 0.04). Conclusion Ultra-hypofractionated low-dose TSEBT followed by systemic therapy seems to be a safe and feasible alternative to conventional fractionated TSEBT for patients with MF/SS. The skin tumor burden and the health-related quality of life have been significantly improved within 8 weeks following radiotherapy.

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“…Chlormethine may be used as monotherapy in early-stage MF, in combination with systemic therapy in advanced-stage disease [25][26][27], and as maintenance treatment [11,28]. The chlormethine gel label indicates daily application; however, the frequency of application may be reduced according to the patient's needs.…”

Section: Chlormethine As Topical Chemotherapy For Managing Mfmentioning

confidence: 99%

Chlormethine Gel for the Treatment of Skin Lesions in All Stages of Mycosis Fungoides Cutaneous T-Cell Lymphoma: A Narrative Review and International Experience

Geskin

Bagot

Hodak

et al. 2021

Dermatol Ther (Heidelb)

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Mycosis fungoides (MF), the most common form of primary cutaneous T-cell lymphoma, is a disease typically with an indolent course that is initially characterized by localized patches and plaques. In the early stages of the disease, treatment involves skin-directed therapies (SDTs) such as topical corticosteroids and retinoids. Chlormethine gel (also known as mechlorethamine) was the first SDT purposely developed to treat MF and is currently endorsed by international guidelines for the treatment of adult patients with MF as a first-line therapy. While chlormethine is an efficacious therapy, its usage may be complicated by the development of cutaneous reactions at the sites of application. Herein, we discuss the supportive guidelines for MF and the suitability of chlormethine as a therapeutic option in patients with MF. In addition, we present realworld experience on the use of chlormethine gel from clinics in the USA, Israel, and France with the aim of demonstrating the efficacy of chlormethine gel in routine clinical practice and outlining strategies that are being used to manage emergent cutaneous reactions.

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Valchlor maintenance therapy for patients with mycosis fungoides who received low dose total skin electron beam treatment

Cited by 20 publications

References 0 publications

Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature

Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature

Acute and sub-acute toxicity profile of ultra-hypofractionated low-dose total skin electron beam with two 4 Gy fractions for cutaneous T cell lymphoma

Chlormethine Gel for the Treatment of Skin Lesions in All Stages of Mycosis Fungoides Cutaneous T-Cell Lymphoma: A Narrative Review and International Experience

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