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SICA A, VITIELLO P, SAGNELLI C, SAGNELLI E, ARGENZIANO G, TROIANI T, CASALE B, MOTTOLA M. Extracorporeal photopheresis in elderly patient with refractory mycosis fungoides. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04383-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Atci T, Baykal C. Efficacy of narrow-band ultraviolet-B therapy in patch-stage mycosis fungoides: A clinical study and review of the literature. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 36:271-277. [PMID: 32145109 DOI: 10.1111/phpp.12547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/20/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND/PURPOSE We investigated the efficacy of narrow-band UVB in patch-stage MF and reviewed the literature to re-evaluate the role of this phototherapy method in early MF. METHODS Early-stage MF patients treated with narrow-band UVB were included. Number of narrow-band UVB treatment sessions, treatment duration, cumulative UV dose, clinical response results, side effects, duration of the remission period and relapse rate were evaluated. RESULTS Complete response rate was 86.7% in sixty patients with MF. Mean number of treatment sessions was 62.9 ± 15.1, treatment duration was 32.1 ± 10.7 weeks, and mean cumulative UV dose was 62.1 ± 41.9 J/cm2 in patients with complete response. Mean duration of remission was 10.3 ± 11.0 months, and relapse rate was 70% in a mean follow-up of 21.9 ± 16.4 months. Mild regional erythema (6.7%) and pruritus (8.3%) were main side effects. There were no significant differences between stage IA and stage IB patients in terms of treatment parameters and duration of remission period. CONCLUSIONS Our study confirms that narrow-band UVB is effective for the management of the patch-stage MF without serious side effects. Extent of the skin lesions did not affect the efficacy of phototherapy. However, due to the short duration of remission, a further option such as an optimal maintenance therapy protocol should be considered.
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Affiliation(s)
- Tugba Atci
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Lack of Durable Remission with Conventional-Dose Total Skin Electron Therapy for the Management of Sezary Syndrome and Multiply Relapsed Mycosis Fungoides. Cancers (Basel) 2019; 11:cancers11111758. [PMID: 31717353 PMCID: PMC6895845 DOI: 10.3390/cancers11111758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/31/2019] [Accepted: 11/02/2019] [Indexed: 02/08/2023] Open
Abstract
Mycosis fungoides (MF) and Sezary syndrome (SS) are multi-relapsing, morbid, cutaneous T-cell lymphomas. Optimal treatment sequencing remains undefined. Total skin electron therapy (TSE) is a highly technical, skin-directed treatment, uniquely producing symptom-free and treatment-free intervals. Recent publications favour low-dose TSE for reduced toxicity, but early data support conventional-dose TSE (cdTSE) for longer disease control. Patient selection requires weighing-up tolerability against response durability. We investigated duration of benefit from cdTSE in patients with poorer prognosis diseases: SS and heavily pre-treated MF. Endpoints were overall survival, and “time to next treatment” (TTNT) as surrogate for clinical benefit duration. Seventy patients (53 MF, 17 SS) were eligible: median prior treatments, 4; median cdTSE dose, 30 Gy; median follow-up, 5.8 years. SS patients had worse prognosis (HR = 5.0, p < 0.001) and shorter TTNT (HR = 4.5, p < 0.001) than MF patients; median TTNT was only 3.7 months. Heavily pre-treated MF patients had inferior prognosis (HR = 1.19 per additional line, p = 0.005), and shorter TTNT (HR = 1.13 per additional line, p = 0.031). Median TTNT for MF patients with ≥3 prior treatments was 7.1 months, versus 23.2 months for 0–2 prior treatments. In conclusion, cdTSE has a limited role in SS. TTNT is reduced in heavily pre-treated MF patients, suggesting greater benefit when utilized earlier in treatment sequencing.
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Chellakhi M, Khalfaoui I, Benchakroun N, Bouchbika Z, Jouhadi H, Tawfiq N, Sahraoui S, Benider A, Chellakhi N, Quessar A. Radiation therapy in mycosis fungoid patient. Pan Afr Med J 2019; 33:227. [PMID: 31692791 PMCID: PMC6814898 DOI: 10.11604/pamj.2019.33.227.17701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/10/2019] [Indexed: 11/29/2022] Open
Abstract
Mycosis fungoid (MF) is a non-Hodgkin's T-cell lymphoma determined by primary cutaneous involvement. It is a slow-progressing chronic indolent disease characterized by atypical T-cells with a cerebral nucleus. Management of this disease depends on the stage and is based essentially on the systemic treatment. Radiotherapy intervenes in case of localized or extended tumor, indeed, the radiosensibility of this tumor, like any other hematological affection, makes it possible to obtain a high rate of response. Clinical case: we report the observation of a 46-year-old patient followed since 2012 for mycosis fungoid revealed by a papullo-squamous lesion located at the level of the right lumbar fossa. The diagnosis was confirmed by cutaneous biopsy, showing the presence of T lymphocytes expressing CD2, CD3, CD4, CCR4, CD45RO markers. Initial assessment included a thoraco-abdominal pelvic CT, which was normal, an accelerated sedimentation rate at the 1st hour, a high C reactive protein (CRP), the electrolytic, renal, hepatic status and the hemogram were normal. Patient received 6 courses of chemotherapy according to the COPP protocol with a decrease in the size of the lesion estimated at 40%. A norm fractionated radiation therapy was delivered at the dose of 36Gy. The evolution was marked by a complete remission, maintained after 6 months of the treatment. Mycosis fungoid is a rare disease, whose management must be discussed in a multidisciplinary team. Radiotherapy remains an interesting option for all stages, but has to be validated in largest studies.
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Affiliation(s)
- Madiha Chellakhi
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Ilham Khalfaoui
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Nadia Benchakroun
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Zineb Bouchbika
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Hassan Jouhadi
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Nezha Tawfiq
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Souha Sahraoui
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Abdellatif Benider
- Centre Mohammed VI de Traitement du Cancer, CHU Ibn Rochd, Casablanca, Maroc
| | - Nabila Chellakhi
- Service d'Hématologie et d'Oncologie Pédiatrique Hopital 20 Aout 1953, CHU Ibn Rochd, Casablanca, Maroc
| | - Asmaa Quessar
- Service d'Hématologie et d'Oncologie Pédiatrique Hopital 20 Aout 1953, CHU Ibn Rochd, Casablanca, Maroc
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Abstract
Cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group of lymphomas that are characterized by primary skin involvement. Mycosis fungoides (MF) and Sézary syndrome (SS), the two most common subtypes of CTCL, can be difficult to manage clinically as there are few effective treatment options available. Recently, histone deacetylase inhibitors (HDACi) have emerged as promising therapies with favorable adverse effect profiles, compared with traditional chemotherapies. In this article, we review the published literature to evaluate the role of HDACi in the treatment of CTCL. Specifically, we (1) briefly discuss the molecular rationale for the use of HDACi in CTCL; (2) compare the efficacy, tolerability, and adverse effects of HDACi; (3) review the cardiac safety data; and (4) discuss optimization of therapy with HDACi in the treatment of CTCL.
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Purnak S, Azar J, Mark LA. Etoposide as a single agent in the treatment of mycosis fungoides: A retrospective analysis. Dermatol Ther 2018; 31:e12586. [DOI: 10.1111/dth.12586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Seda Purnak
- Department of DermatologyIndiana University School of MedicineIndianapolis Indiana
- Deparment of DermatologyUniversity of Health Sciences, Ankara Numune Training and Research HospitalAnkara Turkey
| | - Jose Azar
- Department of Hematology and OncologyIndiana University School of MedicineIndianapolis Indiana
| | - Lawrence Aaron Mark
- Department of DermatologyIndiana University School of MedicineIndianapolis Indiana
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Ghiciuc CM, Strat AL, Ochiuz L, Lupusoru CE, Ignat M, Vasile A, Grigorovici A, Stoleriu I, Solcan C. Inhibition of bcl-2 and cox-2 Protein Expression after Local Application of a New Carmustine-Loaded Clinoptilolite-Based Delivery System in a Chemically Induced Skin Cancer Model in Mice. Molecules 2017; 22:molecules22112014. [PMID: 29156646 PMCID: PMC6150160 DOI: 10.3390/molecules22112014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/06/2017] [Indexed: 02/07/2023] Open
Abstract
Our research has focused on in vitro and in vivo evaluations of a new Carmustine (BCNU)-loaded clinoptilolite-based delivery system. Two clinoptilolite ionic forms-hydrogen form (HCLI) and sodium form (NaCLI)-were prepared, allowing a loading degree of about 5-6 mg BCNU/g of zeolite matrix due to the dual porous feature of clinoptilolite. Clinoptilolite-based delivery systems released 35.23% of the load in 12 h for the BCNU@HCLI system and only 10.82% for the BCNU@NaCLI system. The BCNU@HCLI system was chosen to develop gel and cream semisolid dosage forms. The cream (C_BCNU@HCLI) released 29.6% of the loaded BCNU after 12 h in the Nylon synthetic membrane test and 31.6% in the collagen membrane test, higher by comparison to the gel. The new cream was evaluated in vivo in a chemically induced model of skin cancer in mice. Quantitative immunohistochemistry analysis showed stronger inhibition of B-cell lymphoma-2 (bcl-2) and cyclooxygenase 2 (cox-2) protein expression, known markers for cancer survival and aggressiveness, after the treatment with C_BCNU@HCLI by comparison to all the control treatment types, including an off-label magistral formula commercially available Carmustine cream as reference, bringing evidence that a clinoptilolite-based delivery systems could be used as a cancer drug carriers and controlled release systems (skin-targeted topical delivery systems).
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Affiliation(s)
- Cristina Mihaela Ghiciuc
- Department of Pharmacology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16, University Street, 700115 Iasi, Romania.
| | - Aurel Lulu Strat
- Department of Pharmacology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16, University Street, 700115 Iasi, Romania.
- Laboratory of Microbiology, Hospital of Infectious Diseases "Saint Parascheva", 2, Octav Botez Street, 700116 Iasi, Romania.
| | - Lacramioara Ochiuz
- Department of Pharmaceutical Technology, Faculty of Pharmacy, "Grigore T. Popa" University of Medicine and Pharmacy, 16, University Street, 700115 Iasi, Romania.
| | - Catalina Elena Lupusoru
- Department of Pharmacology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16, University Street, 700115 Iasi, Romania.
| | - Maria Ignat
- Faculty of Chemistry, "Al. I. Cuza" University, 11, Blvd. Carol the 1st, 700560 Iasi, Romania.
| | - Aurelia Vasile
- Faculty of Chemistry, "Al. I. Cuza" University, 11, Blvd. Carol the 1st, 700560 Iasi, Romania.
| | - Alexandru Grigorovici
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16, University Street, 700115 Iasi, Romania.
| | - Iulian Stoleriu
- Faculty of Mathematics, "Al. I. Cuza" University, 11, Blvd. Carol the 1st, 700506 Iasi, Romania.
| | - Carmen Solcan
- Department of Molecular Biology, Histology and Embriology, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine "Ion Ionescu de la Brad", 8, Mihail Sadoveanu Alley, 700489 Iasi, Romania.
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Wilcox RA. Cutaneous T-cell lymphoma: 2017 update on diagnosis, risk-stratification, and management. Am J Hematol 2017; 92:1085-1102. [PMID: 28872191 DOI: 10.1002/ajh.24876] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 12/12/2022]
Abstract
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 TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a "risk-adapted," multi-disciplinary 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 or histone deacetylase inhibitors prior to escalating therapy to include systemic, single-agent chemotherapy. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
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Affiliation(s)
- Ryan A. Wilcox
- Division of Hematology/Oncology; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109-5948
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Puno MIBL, Dimagiba MTE, Jamora MJJ, Montinola FL, Tinio PT. Granulomatous slack skin presenting as diffuse poikiloderma and necrotic ulcers, with features of granulomatous vasculitis and response to oral prednisone, acitretin, and oral psoralen plus ultraviolet light therapy-A case report. JAAD Case Rep 2017; 3:294-300. [PMID: 28748211 PMCID: PMC5512183 DOI: 10.1016/j.jdcr.2017.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | | | | | | | - Patricia Ty Tinio
- Makati Medical Center Department of Dermatology, Quezon City, Philippines
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10
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Kelati A, Gallouj S, Tahiri L, Harmouche T, Mernissi FZ. Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis. Int J Womens Dermatol 2017; 3:100-106. [PMID: 28560304 PMCID: PMC5440453 DOI: 10.1016/j.ijwd.2016.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 01/13/2023] Open
Abstract
Background Mycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease. Methods This was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically. Results MF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis. Conclusions Misdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.
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Affiliation(s)
- A Kelati
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - S Gallouj
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - L Tahiri
- Department of Anatomopathology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - T Harmouche
- Department of Anatomopathology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
| | - F Z Mernissi
- Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco
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11
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How I treat mycosis fungoides and Sézary syndrome. Blood 2016; 127:3142-53. [DOI: 10.1182/blood-2015-12-611830] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/12/2016] [Indexed: 12/11/2022] Open
Abstract
AbstractMycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma variant and is closely related to a rare leukemic variant, Sézary syndrome (SS). MF patients at risk of disease progression can now be identified and an international consortium has been established to address the prognostic relevance of specific biologic factors and define a prognostic index. There are a lack of randomized clinical trial data in MF/SS and evidence is based on a traditional “stage-based” approach; treatment of early-stage disease (IA-IIA) involves skin directed therapies which include topical corticosteroids, phototherapy (psoralen with UVA or UVB), topical chemotherapy, topical bexarotene, and radiotherapy including total skin electron beam therapy. Systemic approaches are used for refractory early-stage and advanced-stage disease (IIB-IV) and include bexarotene, interferon α, extracorporeal photopheresis, histone deacetylase inhibitors, and antibody therapies such as alemtuzumab, systemic chemotherapy, and allogeneic transplantation. However, despite the number of biologic agents available, the treatment of advanced-stage disease still represents an unmet medical need with short duration of responses. Encouragingly, randomized phase 3 trials are assessing novel agents, including brentuximab vedotin and the anti-CCR4 antibody, mogamulizumab. A broader understanding of the biology of MF/SS will hopefully identify more effective targeted therapies.
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12
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Patir P, Vural F. Treatment of mycosis fungoides, in the era of stem cell transplantation. World J Dermatol 2016; 5:52-56. [DOI: 10.5314/wjd.v5.i1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/11/2015] [Accepted: 12/11/2015] [Indexed: 02/06/2023] Open
Abstract
Mycosis fungoides and Sèzary syndrome are the most common subtypes of cutaneous T-cell lymphomas. Even though, in early-stage disease, Mycosis fungoides commonly has a more indolent course, disease will progress in about 20% of such patients. About 30% of patients have been reported to develop advanced-stage disease and, at present, there is no cure for the disease. A number of systemic approaches have been used for advanced-stage mycosis fungoides (IIB-IV) and transformed disease. Aggressive approaches seem to be warranted in such patients. The scope of this review is the stem cell transplantation in mycosis fungoides and its leukemic variant, Sèzary syndrome.
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Wilcox RA. Cutaneous T-cell lymphoma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol 2016; 91:151-65. [PMID: 26607183 PMCID: PMC4715621 DOI: 10.1002/ajh.24233] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 12/11/2022]
Abstract
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 TNMB (tumor, node, metastasis, blood) 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 or histone deacetylase inhibitors before escalating therapy to include systemic, single-agent chemotherapy. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
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Affiliation(s)
- Ryan A. Wilcox
- Division of Hematology/Oncology, University of Michigan Cancer Center, 1500 E. Medical Center Drive, Room 4310 CC, Ann Arbor, MI 48109-5948
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14
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Hughes CFM, Newland K, McCormack C, Lade S, Prince HM. Mycosis fungoides and Sézary syndrome: Current challenges in assessment, management and prognostic markers. Australas J Dermatol 2015; 57:182-91. [DOI: 10.1111/ajd.12349] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/05/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Charlotte FM Hughes
- Division of Haematology and Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Victoria Australia
| | - Kate Newland
- Department of Dermatology; St Vincent's Hospital Department of Medicine; Melbourne Victoria Australia
| | - Christopher McCormack
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Victoria Australia
- Department of Dermatology; St Vincent's Hospital Department of Medicine; Melbourne Victoria Australia
| | - Stephen Lade
- Division of Pathology; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - H Miles Prince
- Division of Haematology and Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Victoria Australia
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15
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Hu SCS. Mycosis fungoides and Sézary syndrome: Role of chemokines and chemokine receptors. World J Dermatol 2015; 4:69-79. [DOI: 10.5314/wjd.v4.i2.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/16/2015] [Accepted: 04/09/2015] [Indexed: 02/06/2023] Open
Abstract
Mycosis fungoides is the most common form of cutaneous T-cell lymphoma (CTCL), and is characterized by a clonal expansion of malignant CD4+ T lymphocytes with skin-homing properties. Clinically and pathologically, mycosis fungoides can be categorized into patch, plaque and tumor stages. The clinical course of mycosis fungoides is usually chronic and indolent, but a proportion of patients may develop progressive disease with peripheral blood, lymph node and visceral organ involvement. Sézary syndrome is an aggressive leukemic form of CTCL characterized by a clonal population of malignant T cells in the peripheral blood. Various forms of skin-directed and systemic treatments are available for mycosis fungoides and Sézary syndrome. However, current treatments are generally not curative, and can only control the disease. Currently, the etiology and pathogenesis of mycosis fungoides and Sézary syndrome are not well defined. Proposed mechanisms include chronic antigenic stimulation by infectious agents, expression of specific adhesion molecules, altered cytokine production, mutations of oncogenes and tumor suppressor genes, and avoidance of apoptosis. In recent years, a number of chemokine receptors and their corresponding chemokine ligands have been found to contribute to the migration and survival of lymphoma cells in mycosis fungoides and Sézary syndrome, including CC chemokine receptor 4 (CCR4), CCR10, C-X-C chemokine receptor type 4 (CXCR4), CCR7, CCR3 and CXCR3. Since chemokines and chemokine receptors have been found to play important roles in the pathophysiology of mycosis fungoides and Sézary syndrome, they may be potentially useful targets for the development of new treatments for these diseases in the future.
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Lack of durable disease control with chemotherapy for mycosis fungoides and Sézary syndrome: a comparative study of systemic therapy. Blood 2015; 125:71-81. [DOI: 10.1182/blood-2014-07-588236] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Key Points
Chemotherapy results in a short median time to next treatment in patients with mycosis fungoides/Sézary syndrome. α-interferon achieves a superior time to next treatment compared with chemotherapy, regardless of stage.
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Slama S, Besbes R. Stereoselective synthesis of erythro-β-chloroamines and their conversion into functionalized trans-oxazolidin-2-ones. Tetrahedron 2014. [DOI: 10.1016/j.tet.2014.05.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Wilcox RA. Cutaneous T-cell lymphoma: 2014 update on diagnosis, risk-stratification, and management. Am J Hematol 2014; 89:837-51. [PMID: 25042790 DOI: 10.1002/ajh.23756] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 12/12/2022]
Abstract
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 TNMB (tumor, node, metastasis, and blood) 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 or histone deacetylase inhibitors prior to escalating therapy to include systemic, single-agent chemotherapy. Multiagent chemotherapy (e.g., CHOP) may be employed for those patients with extensive visceral involvement requiring rapid disease control. In highly selected patients, allogeneic stem-cell transplantation may be considered.
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Affiliation(s)
- Ryan A. Wilcox
- Division of Hematology/Oncology; University of Michigan Cancer Center; Ann Arbor Michigan
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Mazzeo E, Rubino L, Buglione M, Antognoni P, Magrini SM, Bertoni F, Parmiggiani M, Barbieri P, Bertoni F. The current management of mycosis fungoides and Sézary syndrome and the role of radiotherapy: Principles and indications. Rep Pract Oncol Radiother 2014; 19:77-91. [PMID: 24936325 PMCID: PMC4054991 DOI: 10.1016/j.rpor.2013.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/17/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022] Open
Abstract
AIM To evaluate the current treatment of mycosis fungoides (MF) and Sézary syndrome (SS) focusing on the role of radiotherapy (RT), its principles and indications, and the perspectives of the novel irradiation technologies. BACKGROUND MF and SS are rare lymphoproliferative diseases whose incidence is increasing. For a long time RT has been used as a single modality or in integrated treatment programs for these diseases. MATERIALS AND METHODS The latest systematic reviews, primary studies and new diagnostic and treatment guidelines on MF and SS were analyzed. Clinical outcomes together with the technical aspects and the role of RT were also evaluated. RESULTS New data are available on pathogenesis, diagnostic criteria, classification and staging procedures for MF and SS and several local and systemic therapies are proposed. Localized RT can cure "minimal stage" MF while total skin electron beam irradiation (TSEI) may cure initial-stage disease and may offer important symptom relief (itch, erythroderma) in a more advanced setting. Despite its efficacy, RT is not largely used, mainly because of some technical difficulties but new RT technologies may be proposed to treat large skin surfaces. CONCLUSIONS New treatment programs offer good results, with median survival of more than 12 years in early-stage MF, but the median survival of 2.5 years or less in advanced stages is still a challenge. RT remains an option for all stages with a good cost/effectiveness ratio in a curative or palliative setting. New RT technologies can overcome some technical problems of treating large skin surfaces.
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Affiliation(s)
- Ercole Mazzeo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Laura Rubino
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Michela Buglione
- Department of Radiation Oncology, Brescia University, Istituto del Radio “O. Alberti”, Brescia, Italy
| | - Paolo Antognoni
- Department of Radiotherapy, Azienda Ospedaliera Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Brescia University, Istituto del Radio “O. Alberti”, Brescia, Italy
| | - Francesco Bertoni
- Department of Radiation Oncology, Brescia University, Istituto del Radio “O. Alberti”, Brescia, Italy
| | - Manuela Parmiggiani
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Paola Barbieri
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Filippo Bertoni
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
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Iwatsuki K, Hamada T. Current therapy of choice for cutaneous lymphomas: Complementary to the Japanese Dermatological Association/Japanese Skin Cancer Society guidelines. J Dermatol 2014; 41:43-9. [DOI: 10.1111/1346-8138.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 10/21/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Keiji Iwatsuki
- Departments of Dermatology; Okayama University Graduate; School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - Toshihisa Hamada
- Departments of Dermatology; Okayama University Graduate; School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
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Gamble M, Tocci E, DeSimone JA. Low Dose Total Skin Electron Beam Radiation in Cutaneous T-Cell Lymphoma: Review. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/jct.2014.514138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Atalla A, Hallack Neto AE, Siqueira DB, Toledo GC. Allogeneic hematopoietic stem cell transplantation in mycosis fungoides. An Bras Dermatol 2013; 88:216-9. [PMID: 24346924 PMCID: PMC3875963 DOI: 10.1590/abd1806-4841.20132365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/06/2013] [Indexed: 11/21/2022] Open
Abstract
Mycosis Fungoides is typically an indolent disease in early stages. However, approximately 30% of patients have advanced staged disease at presentation and 20% will develop it at some time. These patients have a poorer prognosis with a median survival of 2-4 years. The only curative option for mycosis fungoides may be hematopoietic allogeneic stem cell transplantation. We report the case of a patient with mycosis fungoides in an advanced stage (IIB), refractory to treatment options. She underwent allogeneic hematopoietic stem-cell transplantation (allo-HSCT). The patient remains in complete remission nineteen months after allo-HSCT. Allogeneic transplantation can alter the natural history of mycosis fungoides and should be considered in patients who have refractory disease or short-lived responses with standard therapies.
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Abstract
PURPOSE The pharmacology, pharmacokinetic and pharmacodynamic properties, and clinical data on a novel therapy for the treatment of cutaneous or peripheral T-cell lymphoma (CTCL, PTCL) are summarized. SUMMARY Romidepsin is the only bicyclic histone deacetylase (HDAC) inhibitor to undergo clinical development. A potent and specific inhibitor of class 1 HDACs, romidepsin has linear pharmacokinetics and is primarily metabolized by cytochrome P-450 isoenzyme 3A4. In two Phase II studies involving patients with relapsed or refractory CTCL, romidepsin therapy produced overall response rates of 34-35% (including patients with advanced and heavily pretreated disease), with a complete response seen in about 6% of patients in both studies; romidepsin responses were seen across all evaluated disease sites (skin, blood, lymph, viscera). In two Phase II studies in patients with relapsed or refractory PTCL, romidepsin produced overall response rates of 25-38%, and 15-18% of patients experienced a complete response; therapeutic responses were seen across major PTCL subtypes regardless of the number or types of previous therapies or refractoriness to the last prior therapy. In clinical trials to date, romidepsin therapy was generally well tolerated, with nausea, fatigue, and vomiting reported as the most common nonhematologic adverse events. However, thrombocytopenia and neutropenia are relatively common events, especially in patients with PTCL. CONCLUSION Romidepsin, a class 1-specific HDAC inhibitor, induces durable responses, with a manageable toxicity profile, in patients with relapsed or refractory CTCL or PTCL who have few therapeutic options.
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Affiliation(s)
- Angie L McGraw
- Middle Tennessee Medical Center, 1700 Medical Center Parkway, Murfreesboro, TN 37129, USA.
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Hensley FW, Major G, Edel C, Hauswald H, Bischof M. Technical and dosimetric aspects of the total skin electron beam technique implemented at Heidelberg University Hospital. Rep Pract Oncol Radiother 2013; 19:135-43. [PMID: 24936332 DOI: 10.1016/j.rpor.2013.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/04/2013] [Indexed: 12/25/2022] Open
Abstract
AIM To give a technical description and present the dosimetric proporties of the total skin electron beam technique implemented at Heidelberg University Hospital. BACKGROUND Techniques used for total skin electron beam irradiation were developed as early as in the 1960s to 1980s and have, since then, hardly changed. However, new measurements of the established methods allow deeper insight into the dose distributions and reasons for possible deviations from uniform dose. MATERIALS AND METHODS The TSEI technique applied at Heidelberg University Hospital since 1992 consists of irradiating the patient with a superposition of two beams of low energy electrons at gantry angles of 72° and 108° while he is rotating in a standing position on a turntable at 370 cm distance from the accelerator. The energy of the electron beam is degraded to 3.9 MeV by passing through an attenuator of 6 mm of Perspex. A recent re-measurement of the dose distribution is presented using modern dosimetry tools like a linear array of ionization chambers in combination with established methods like thermoluminescent detectors and film dosimetry. RESULTS The measurements show a strong dependence of dose uniformity on details of the setup like gantry angles. CONCLUSIONS Dose uniformity of -4/+8% to the majority of the patient's skin can be achieved, however, for the described rotational technique overdoses up to more than 20% in small regions seem unavoidable.
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Affiliation(s)
- Frank W Hensley
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Gerald Major
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Carolin Edel
- Department of Radiation Protection, Zentralbereich Neuenheimer Feld, University of Heidelberg, Im Neuenheimer Feld 327, 69120 Heidelberg, Germany
| | - Henrik Hauswald
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Marc Bischof
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Schlaak M, Pickenhain J, Theurich S, Skoetz N, von Bergwelt‐Baildon M, Kurschat P. Allogeneic stem cell transplantation versus conventional therapy for advanced primary cutaneous T-cell lymphoma. Cochrane Database Syst Rev 2013; 2013:CD008908. [PMID: 23986525 PMCID: PMC7156921 DOI: 10.1002/14651858.cd008908.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Primary cutaneous T-cell lymphomas (CTCL) belong to the group of non-Hodgkin lymphomas and usually run an indolent course. However, some patients progress to advanced tumour or leukaemic stages. To date, there is no cure for those cases. In the last few years, several publications reported durable responses in some patients following allogeneic stem cell transplantation (alloSCT). This is an update of a Cochrane review first published in 2011 and updated in 2013. OBJECTIVES To compare the efficacy and safety of conventional therapies with allogeneic stem cell transplantation in patients with advanced primary cutaneous T-cell lymphomas. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1), MEDLINE (1950 to January 2013), Internet-databases of ongoing trials, conference proceedings of the American Society of Clinical Oncology (ASCO, 2009 to July 2013) and the American Society of Hematology (ASH, 2009 to July 2013). We also contacted members of the European Organisation for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Task Force to check for ongoing study activities. We handsearched citations from identified trials and relevant review articles. In addition, we handsearched randomised controlled trials from the European Group for Blood and Marrow Transplantation (EBMT) and International Conference on Cutaneous T-cell Lymphoma, ASCO and ASH up to July 2013. SELECTION CRITERIA Trials eligible for inclusion were genetically randomised controlled trials (RCTs) comparing alloSCT plus conditioning therapy (regardless of agents) with conventional therapy as treatment for advanced CTCL. DATA COLLECTION AND ANALYSIS Two review authors would have extracted data from eligible studies and assessed their quality. The primary outcome measure was overall survival; secondary outcomes were time to progression, response rate, treatment-related mortality, adverse events and quality of life. MAIN RESULTS We did not identify any randomised controlled trials from the updated search in January 2013. In 2011, we found 2077 citations but none were relevant genetically or non-genetically randomised controlled trials. All 41 studies that were thought to be potentially suitable were excluded after full text screening for being non-randomised, not including CTCL or being review articles. AUTHORS' CONCLUSIONS We planned to report evidence from genetically or non-genetically randomised controlled trials comparing conventional therapy and allogeneic stem cell transplantation. However, we did not identify any randomised controlled trials addressing this question. Nevertheless, prospective genetically randomised controlled trials need to be initiated to evaluate the precise role of alloSCT in advanced CTCL.
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Affiliation(s)
- Max Schlaak
- University Hospital of CologneDepartment of Dermatology and VenerologyKerpener Str. 62CologneGermany50924
| | - Juliane Pickenhain
- University Hospital of CologneDepartment of Dermatology and VenerologyKerpener Str. 62CologneGermany50924
| | - Sebastian Theurich
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramKerpener Str. 62CologneGermany50924
| | - Nicole Skoetz
- University Hospital of CologneCochrane Haematological Malignancies Group, Department I of Internal MedicineKerpener Str. 62CologneGermany50924
| | - Michael von Bergwelt‐Baildon
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramKerpener Str. 62CologneGermany50924
| | - Peter Kurschat
- University Hospital of CologneDepartment of Dermatology and VenerologyKerpener Str. 62CologneGermany50924
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A cutaneous lymphoma international prognostic index (CLIPi) for mycosis fungoides and Sezary syndrome. Eur J Cancer 2013; 49:2859-68. [PMID: 23735705 DOI: 10.1016/j.ejca.2013.04.018] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 04/22/2013] [Accepted: 04/23/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is no prognostic index for primary cutaneous T-cell lymphomas such as mycosis fungoides (MF) and Sezary syndrome (SS). METHOD Two prognostic indices were developed for early (IA-IIA) and late stage (IIB-IVB) disease based on multivariate data from 1502 patients. End-points included overall survival (OS) and progression free survival (PFS). External validation included 1221 patients. FINDINGS Significant adverse prognostic factors at diagnosis consisted of male gender, age >60, plaques, folliculotropic disease and stage N1/Nx for early stage, and male gender, age >60, stages B1/B2, N2/3 and visceral involvement for late stage disease. Using these variables we constructed two separate models each defined using 3 distinct groups for early and late stage patients: 0-1 (low risk), 2 (intermediate risk), and 3-5 factors (high risk). 10 year OS in the early stage model was 90.3% (low), 76.2% (intermediate) and 48.9% (high) and for the late stage model 53.2% (low), 19.8% (intermediate) and 15.0% (high). For the validation set significant differences in OS and PFS in early stage patients (both p<0.001) were also noted. In late stage patients, only OS differed between the groups (p=0.002). INTERPRETATION This proposed cutaneous lymphoma prognostic index provides a model for prediction of OS in early and late stage MF/SS enabling rational therapeutic choices and patient stratification in clinical trials.
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Fernández-Guarino M, Jaén-Olasolo P. Terapia fotodinámica en micosis fungoides. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2012.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Photodynamic therapy in mycosis fungoides. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:393-9. [PMID: 23664412 DOI: 10.1016/j.adengl.2012.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 11/07/2012] [Indexed: 11/23/2022] Open
Abstract
Photodynamic therapy involves the topical application of a photosensitizer to a lesion, which is then subsequently exposed to a light source. It is mainly used in the nonsurgical treatment of nonmelanoma skin cancer, in which it achieves good response and an excellent cosmetic result. In the last 10 years, photodynamic therapy has also been used with some success in the treatment of plaque-stage mycosis fungoides and has emerged as an alternative to skin-directed therapies. Its main advantages are the good response to treatment, lack of toxicity, and excellent cosmetic results. This article reviews the literature and the practical application of photodynamic therapy in mycosis fungoides.
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Abstract
Mycosis fungoides is a candidate for skin-directed therapies in its initial stages. In recent years, therapeutic options outside of the normal treatment recommendations such as topical imiquimod, topical tazarotene, topical methotrexate, excimer light sources, and photodynamic therapy have been published with variable results. These alternatives have been useful in cases of localized mycosis fungoides that do not respond to routine treatments; nevertheless, more studies on these methods are still needed. This article summarizes the literature and data that are known so far about these treatments.
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Allogeneic stem cell transplantation for advanced primary cutaneous T-cell lymphoma: A systematic review. Crit Rev Oncol Hematol 2013; 85:21-31. [DOI: 10.1016/j.critrevonc.2012.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 05/13/2012] [Accepted: 06/12/2012] [Indexed: 11/23/2022] Open
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Nasto LA, Wang D, Robinson AR, Clauson CL, Ngo K, Dong Q, Roughley P, Epperly M, Huq SM, Pola E, Sowa G, Robbins PD, Kang J, Niedernhofer LJ, Vo NV. Genotoxic stress accelerates age-associated degenerative changes in intervertebral discs. Mech Ageing Dev 2012; 134:35-42. [PMID: 23262094 DOI: 10.1016/j.mad.2012.11.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 11/19/2012] [Accepted: 11/24/2012] [Indexed: 01/09/2023]
Abstract
Intervertebral disc degeneration (IDD) is the leading cause of debilitating spinal disorders such as chronic lower back pain. Aging is the greatest risk factor for IDD. Previously, we demonstrated IDD in a murine model of a progeroid syndrome caused by reduced expression of a key DNA repair enzyme. This led us to hypothesize that DNA damage promotes IDD. To test our hypothesis, we chronically exposed adult wild-type (Wt) and DNA repair-deficient Ercc1(-/Δ) mice to the cancer therapeutic agent mechlorethamine (MEC) or ionization radiation (IR) to induce DNA damage and measured the impact on disc structure. Proteoglycan, a major structural matrix constituent of the disc, was reduced 3-5× in the discs of MEC- and IR-exposed animals compared to untreated controls. Expression of the protease ADAMTS4 and aggrecan proteolytic fragments was significantly increased. Additionally, new PG synthesis was reduced 2-3× in MEC- and IR-treated discs compared to untreated controls. Both cellular senescence and apoptosis were increased in discs of treated animals. The effects were more severe in the DNA repair-deficient Ercc1(-/Δ) mice than in Wt littermates. Local irradiation of the vertebra in Wt mice elicited a similar reduction in PG. These data demonstrate that genotoxic stress drives degenerative changes associated with IDD.
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Affiliation(s)
- Luigi A Nasto
- Ferguson Laboratory for Orthopaedic Research, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
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Tomita H, Ogawa F, Kuwatsuka S, Toriyama F, Yasumoto S, Kamihira S, Utani A. Attenuation of an adult T-cell leukemia skin lesion after treatment of a concomitant herpes simplex infection: a case study. Virol J 2012; 9:224. [PMID: 23021252 PMCID: PMC3519532 DOI: 10.1186/1743-422x-9-224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 09/26/2012] [Indexed: 11/10/2022] Open
Abstract
We report the development and treatment of eczema herpeticum in a 51-year-old male suffering from adult T-cell leukemia (ATL). Lesions of eczema herpeticum coexisted with the skin lesions of ATL. Treatment of eczema herpeticum resulted in a concomitant improvement in the symptoms of ATL, including a reduction in the size of the ATL plaques, for over 2 months before relapse.
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Affiliation(s)
- Hajime Tomita
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Schlaak M, Pickenhain J, Theurich S, Skoetz N, von Bergwelt-Baildon M, Kurschat P. Allogeneic stem cell transplantation versus conventional therapy for advanced primary cutaneous T-cell lymphoma. Cochrane Database Syst Rev 2012; 1:CD008908. [PMID: 22258991 DOI: 10.1002/14651858.cd008908.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Primary cutaneous T-cell lymphomas (CTCL) belong to the group of non-Hodgkin lymphomas and usually run an indolent course. However, some patients progress to advanced tumour or leukaemic stages. Up to now, no curative treatment has been established for those cases. In the last few years, several publications have reported durable responses in some patients following allogeneic stem cell transplantation (alloSCT). OBJECTIVES To compare the efficacy and safety of conventional therapies with allogeneic stem cell transplantation in patients with advanced primary cutaneous T-cell lymphomas. SEARCH METHODS The search strategy included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1950 to May 2011), Internet-databases of ongoing trials (www.controlled-trials.com; www.clinicaltrials.gov), conference proceedings of the American Society of Clinical Oncology (ASCO, 2009 to present) and the American Society of Hematology (ASH, 2009 to present). We also contacted members of the European Organisation for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Task Force to check for ongoing study activities. We handsearched citations from identified trials and relevant review articles. In addition, randomised controlled trials from the European Group for Blood and Marrow Transplantation (EBMT) and International Conference on Cutaneous T-cell Lymphoma, ASCO and ASH up to 2010 were handsearched. SELECTION CRITERIA Genetically randomised controlled trials (RCT) comparing alloSCT plus conditioning therapy regardless of agents with conventional therapy as treatment for advanced CTCL were eligible to be included. DATA COLLECTION AND ANALYSIS From eligible studies data would have been extracted by two review authors and assessed for quality. Primary outcome measures were overall survival, secondary criteria were time to progression, response rate, treatment-related mortality, adverse events and quality of life. MAIN RESULTS We found 2077 citations but none were relevant genetically or non-genetically randomised controlled trials. All 41 studies that were thought to be potentially suitable were excluded after full text screening for being non-randomised, not including CTCL or being review articles. AUTHORS' CONCLUSIONS We planned to report evidence from genetically or non-genetically randomised controlled trials comparing conventional therapy and allogeneic stem cell transplantation. However, no randomised trials addressing this question were identified. Nevertheless, prospective genetically randomised controlled trials need to be initiated to evaluate the precise role of alloSCT in advanced CTCL.
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Affiliation(s)
- Max Schlaak
- Department ofDermatology andVenerology,UniversityHospital ofCologne,Cologne,Germany.
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The Use of Methotrexate in Dermatology / Upotreba metotreksata u dermatologiji. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2011. [DOI: 10.2478/v10249-011-0045-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Methotrexate is a cytotoxic antimetabolite agent and a folic acid antagonist. Except for its use in oncology and rheumatology, it is widely used in dermatology. The most important indications include severe forms of psoriasis, but also a wide range of autoimmune diseases and dermatoses with different etiology and pathophysiology such as: bullous pemphigoid, dermatomyositis, pityriasis rubra pilaris, sarcoidosis, T-cell lymphomas, Behcet’s disease, adult atopic eczema, scleroderma, Reiter’s syndrome and many others. For dermatological indications methotrexate is usually taken in low oral doses, 5-25 mg once a week. In certain diseases it can be applied to the lesion itself, or in the form of local preparations. Considering the fact that numerous drugs affect various metabolic phases of methotrexate and may increase its toxicity, it is of utmost importance to consider other prescribed drugs, especially certain antibiotics, nonsteroidal antiinflammatory drugs, antiepileptic drugs, retinoids, proton pump inhibitors and so on. If the selection of patients is correct, if drugs are taken regularly and laboratory monitoring is included, methotrexate is a truly efficient and safe drug that can be taken for months or years if necessary.
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Wilcox RA. Cutaneous T-cell lymphoma: 2011 update on diagnosis, risk-stratification, and management. Am J Hematol 2011; 86:928-48. [PMID: 21990092 DOI: 10.1002/ajh.22139] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Ryan A Wilcox
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Cancer Center, Ann Arbor, 48109-5948, USA. rywilcox@med. umich.edu
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Donor lymphocyte infusions combined with systemic PUVA/bexarotene as an effective bimodal immunologic approach in a patient with relapsed cutaneous T cell lymphoma after allogeneic stem cell transplantation. Transpl Immunol 2011; 25:163-6. [DOI: 10.1016/j.trim.2011.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/25/2011] [Accepted: 06/25/2011] [Indexed: 11/18/2022]
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Querfeld C, Kuzel TM, Kim YH, Porcu P, Duvic M, Musiek A, Rook AH, Mark LA, Pinter-brown L, Hamid O, Lin B, Bian Y, Boye M, Day JM, Rosen ST. Multicenter phase II trial of enzastaurin in patients with relapsed or refractory advanced cutaneous T-cell lymphoma. Leuk Lymphoma 2011; 52:1474-80. [DOI: 10.3109/10428194.2011.572265] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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[Sustained molecular remission in an adult patient with Sézary syndrome after peripheral allogeneic stem-cell transplantation]. Med Clin (Barc) 2011; 136:317-8. [PMID: 20462612 DOI: 10.1016/j.medcli.2010.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 03/04/2010] [Accepted: 03/04/2010] [Indexed: 11/20/2022]
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Poligone B, Lin J, Chung C. Romidepsin: evidence for its potential use to manage previously treated cutaneous T cell lymphoma. CORE EVIDENCE 2010; 6:1-12. [PMID: 21468238 PMCID: PMC3065556 DOI: 10.2147/ce.s9084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Indexed: 11/23/2022]
Abstract
Introduction: Cutaneous T cell lymphoma (CTCL) encompasses a heterogeneous group of neoplasms of skin-homing T cells, which includes mycosis fungoides, the most common form, and Sézary syndrome, the leukemia equivalent of mycosis fungoides. Histone deacetylase inhibitors are currently under investigation for their therapeutic value in a variety of conditions. Through multiple mechanisms, they induce apoptosis or inhibition of tumor cell growth. Some studies have also shown histone deacetylase inhibitors to have synergistic activity with existing therapeutic agents in selected conditions. Romidepsin is a histone deacetylase inhibitor with a promising efficacy and safety profile that may represent a valuable treatment alternative for patients with treatment-resistant mycosis fungoides and Sézary syndrome. Aims: To review emerging evidence regarding the use of romidepsin in the management of treatment-resistant CTCL. Evidence review: There is evidence that romidepsin can induce significant and durable responses in patients with refractory CTCL. In two independent Phase II trials including a total of 167 patients with CTCL, there was an overall response rate of 34% with a partial response of 28% and complete response rate of 6%. The most frequent toxicities reported from the Phase II trials were nausea, vomiting, fatigue, anorexia, and dysgeusia. Clinical potential: Romidepsin may be an effective therapeutic option for patients with CTCL who have had treatment failure with multiple standard treatment modalities.
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Affiliation(s)
- Brian Poligone
- Wilmot Cancer Center, Department of Dermatology, University of Rochester School of Medicine, Rochester, NY, USA
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Chandesris MO, Malamut G, Verkarre V, Meresse B, Macintyre E, Delarue R, Rubio MT, Suarez F, Deau-Fischer B, Cerf-Bensussan N, Brousse N, Cellier C, Hermine O. Enteropathy-associated T-cell lymphoma: a review on clinical presentation, diagnosis, therapeutic strategies and perspectives. ACTA ACUST UNITED AC 2010; 34:590-605. [PMID: 21050687 DOI: 10.1016/j.gcb.2010.09.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Enteropathy-associated T-cell lymphoma (EATL) is a rare complication of celiac disease (<1% of lymphomas) and has a poor prognosis. METHODS International literature review with PubMed search (up to January 2009) of pathophysiological, clinical and therapeutic data. RESULTS EATL is found in patients with a mean age of 59 years, often with a complication that signals its diagnosis. Refractory celiac disease (RCD), equivalent to low-grade intraepithelial T-cell lymphoma, could be an intermediary between celiac disease and high-grade invasive T-cell lymphoma. The median survival is 7 months, with no significant difference between stages; the cumulative 5-year survival is less than 20%. The poor prognosis is determined by disease that has often spread before it is diagnosed (50%), multifocal involvement of the small bowel (50%), poor general health status and undernutrition, and recurrence of complications (infections, perforations, gastrointestinal haemorrhages, occlusions), thus delaying the chemotherapy and contributing to frequent chemotherapy resistance. There is currently no effective and consensual treatment: preventive surgery for complications is controversial, and the results of chemotherapy are disappointing. The classic CHOP protocol (combination of doxorubicin-cyclophosphamide-vincristine-prednisone) does not have satisfactory results and survival remains poor, especially in patients with underlying RCD. High-dose chemotherapy with autotransplantion seems to only improve the prognosis in localised forms. Allogeneic bone marrow transplantation was not evaluated. In all, 1/3 of patients, being unfit for treatment, die before 3 months and half of treated patients stop chemotherapy prematurely due to inefficacy, intolerance and/or complications. CONCLUSION Improvement of the prognosis requires collaboration in order to compose a national cohort, to evaluate new diagnostic and therapeutic strategies and to define prognostic factors.
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Affiliation(s)
- M-O Chandesris
- Service d'hématologie adulte, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, université Paris V-René-Descartes, 149, rue de Sèvres, 75743 Paris cedex 15, France
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Fernández-Guarino M, Harto A, Pérez-García B, Montull C, De Las Heras E, Jaén P. Micosis fungoide en fase de placas tratada con terapia fotodinámica: resultados en 12 pacientes. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/j.ad.2010.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Whittaker SJ, Demierre MF, Kim EJ, Rook AH, Lerner A, Duvic M, Scarisbrick J, Reddy S, Robak T, Becker JC, Samtsov A, McCulloch W, Kim YH. Final Results From a Multicenter, International, Pivotal Study of Romidepsin in Refractory Cutaneous T-Cell Lymphoma. J Clin Oncol 2010; 28:4485-91. [DOI: 10.1200/jco.2010.28.9066] [Citation(s) in RCA: 500] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeThe primary objective of this study was to confirm the efficacy of romidepsin in patients with treatment refractory cutaneous T-cell lymphoma (CTCL).Patients and MethodsThis international, pivotal, single-arm, open-label, phase II study was conducted in patients with stage IB to IVA CTCL who had received one or more prior systemic therapies. Patients received romidepsin as an intravenous infusion at a dose of 14 mg/m2on days 1, 8, and 15 every 28 days. Response was determined by a composite assessment of total tumor burden including cutaneous disease, lymph node involvement, and blood (Sézary cells).ResultsNinety-six patients were enrolled and received one or more doses of romidepsin. Most patients (71%) had advanced stage disease (≥ IIB). The response rate was 34% (primary end point), including six patients with complete response (CR). Twenty-six of 68 patients (38%) with advanced disease achieved a response, including five CRs. The median time to response was 2 months, and the median duration of response was 15 months. A clinically meaningful improvement in pruritus was observed in 28 (43%) of 65 patients, including patients who did not achieve an objective response. Median duration of reduction in pruritus was 6 months. Drug-related adverse events were generally mild and consisted mainly of GI disturbances and asthenic conditions. Nonspecific, reversible ECG changes were noted in some patients.ConclusionRomidepsin has significant and sustainable single-agent activity (including improvement in pruritus) and an acceptable safety profile, making it an important therapeutic option for treatment refractory CTCL.
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Affiliation(s)
- Sean J. Whittaker
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Marie-France Demierre
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Ellen J. Kim
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Alain H. Rook
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Adam Lerner
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Madeleine Duvic
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Julia Scarisbrick
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Sunil Reddy
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Tadeusz Robak
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Jürgen C. Becker
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Alexey Samtsov
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - William McCulloch
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
| | - Youn H. Kim
- From Guy's and St Thomas' National Health Service Foundation Trust; Kings College London, London, United Kingdom; Boston Medical Center, Boston; Gloucester Pharmaceuticals, Cambridge, MA; Hospital of the University of Pennsylvania, Philadelphia, PA; M. D. Anderson Cancer Center, Houston TX; Stanford Cancer Center, Stanford, CA; Medical University of Lodz, Lodz, Poland; Univeritätsklinikum, Würzburg, Germany; and Akademika Lebedeva, Saint-Petersburg, Russia
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Beylot-Barry M, Dereure O, Vergier B, Barete S, Laroche L, Machet L, Delfau-Larue MH, D’Incan M, Grange F, Ortonne N, Merlio JP, Bagot M. Prise en charge des lymphomes T cutanés : recommandations du Groupe français d’étude des lymphomes cutanés. Ann Dermatol Venereol 2010; 137:611-21. [DOI: 10.1016/j.annder.2010.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 04/19/2010] [Accepted: 06/22/2010] [Indexed: 10/19/2022]
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Abstract
Cutaneous T-cell lymphoma (CTCL) is a malignancy derived from a clonal population of mature, skin-homing lymphocytes. In the skin, the CTCL cells are associated with the Langerhans cells and respond to protumor cytokines. In turn, they upregulate T-cell receptor-dependent signaling pathways and subsequently demonstrate stigmata of T-cell activation. As the disease progresses, there appears to be an accumulation of genetic and epigenetic changes that may contribute to the aggressiveness of the disease. Furthermore, the persistence of tumor appears to require escape from cancer immunosurveillance. This process likely requires modulation of the host immune system and skewing of the immune cells away from a cytotoxic phenotype. Each of these steps in disease pathogenesis offers a potential object for targeted therapies. This article reviews the recent research into the design and use of targeted therapies for CTCL.
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D'hooghe M, Catak S, Stanković S, Waroquier M, Kim Y, Ha HJ, Van Speybroeck V, De Kimpe N. Systematic Study of Halide-Induced Ring Opening of 2-Substituted Aziridinium Salts and Theoretical Rationalization of the Reaction Pathways. European J Org Chem 2010. [DOI: 10.1002/ejoc.201000486] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hymes KB. The Role of Histone Deacetylase Inhibitors in the Treatment of Patients With Cutaneous T-Cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2010; 10:98-109. [DOI: 10.3816/clml.2010.n.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Calzado-Villarreal L, Polo-Rodríguez I, Ortiz-Romero P. Primary Cutaneous CD30+ Lymphoproliferative Disorders. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/s1578-2190(10)70598-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Calzado-Villarreal L, Polo-Rodríguez I, Ortiz-Romero P. Síndrome linfoproliferativo CD30+ cutáneo primario. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/j.ad.2009.07.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fernández-Guarino M, Harto A, Pérez-García B, Montull C, De Las Heras E, Jaén P. Plaque-Phase Mycosis Fungoides Treated with Photodynamic Therapy: Results from 12 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/s1578-2190(10)70717-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Duvic M, Olsen EA, Breneman D, Pacheco TR, Parker S, Vonderheid EC, Abuav R, Ricker JL, Rizvi S, Chen C, Boileau K, Gunchenko A, Sanz-Rodriguez C, Geskin LJ. Evaluation of the Long-Term Tolerability and Clinical Benefit of Vorinostat in Patients With Advanced Cutaneous T-Cell Lymphoma. ACTA ACUST UNITED AC 2009; 9:412-6. [DOI: 10.3816/clm.2009.n.082] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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