Multicenter photopheresis intervention trial in early-stage mycosis fungoides

Rakhshandra Talpur, Marie Francis Demierre, Larisa Geskin, Elma Baron, Silvina Pugliese, Kelley Eubank, John A. Zic, Donald R. Miller, Michael Tharp, Kimberly Bohjanen, Madeleine Duvic

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Purpose: To demonstrate the efficacy of the UVAR XTS Photopheresis System and evaluate health-related quality of life in patients with early-stage mycosis fungoides (MF). Patients and Methods: Extracorporeal photopheresis was administered 2 days every 4 weeks for 6 months. Patients with partial responses by skin weighted assessment continued for 6 months; nonresponders added oral bexarotene and/or interferon α. Health-related quality of life was assessed at baseline and every 3 months with 3 validated tools. Results: Nineteen patients with early-stage MF (7 men, 12 women; 16 white, 3 African Americans) with median age of 63.5 years (range, 46-85 years) participated. Their stages were IA (n = 3), IB (n = 14), and IIA (n = 2). The overall response rate for extracorporeal photopheresis (ECP) alone, was 42% (8/19; including 7 partial response, 1 complete response), with a median of 12 ECP sessions (range, 3-32) given over a median of 12 months (3-32 months) and with an overall duration of response of 6.5 months (range, 1-48 months). Seven patients with stable disease at 3 months received additional bexarotene (3/5; 1 complete response) or bexarotene plus interferon α (1/2), and 4 (57%) of 7 responded. Treatment-related adverse effects were limited to those expected with interferon (fatigue, nausea, vomiting, and diarrhea), or with hypertriglyceridemia and bexarotene. Trends in health-related quality of life indicated an improvement in emotional scores over time. Conclusions: ECP is effective for patients with early-stage MF alone or in combination with biologic response modifiers with low toxicity and improved quality of life.

Original languageEnglish (US)
Pages (from-to)219-227
Number of pages9
JournalClinical Lymphoma, Myeloma and Leukemia
Volume11
Issue number2
DOIs
StatePublished - Apr 2011

Keywords

  • Bexarotene
  • Extracorporeal photopheresis
  • Interferon
  • Mycosis Fungoides
  • Sézary syndrome

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