 |
|
Extracorporeal Photopheresis in Sézary Syndrome
No Significant Effect in the Survival of 44 Patients With a Peripheral Blood T-Cell Clone
Elisabeth Fraser-Andrews, MA, MRCP;
Paul Seed, MSc;
Sean Whittaker, MD, MRCP;
Robin Russell-Jones, MA, FRCP
Arch Dermatol. 1998;134:1001-1005.
Background Several retrospective studies have claimed that extracorporeal photopheresis (ECP) prolongs survival in patients with erythrodermic cutaneous T-cell lymphoma. In a retrospective study of 44 patients with Sézary syndrome, we compared survival in patients treated with ECP with that of patients treated conventionally at the same institute. All patients had genotypic evidence of a peripheral blood T-cell clone.
Observations Twenty-nine patients received ECP (group 1); 15 patients did not receive ECP, 8 patients when ECP was available (group 2) and 7 before ECP was available (group 3). Forty-three of 44 patients received other conventional treatments. Median survival from diagnosis of Sézary syndrome was 39 months in group 1, 22 months in group 2, and 27.5 months in group 3 (Kaplan-Meier analysis). Cox regression analysis showed no significant difference between the 3 groups after correcting for age, sex, and initial Sézary cell count (hazard ratio, 0.56; 95% confidence interval, 0.26-1.17; P =.12).
Conclusions This study does not support the contention that ECP prolongs survival in patients with Sézary syndrome. The median survival in the ECP-treated group is considerably less than that reported in other published series, possibly because genotypic evidence of clonality in the peripheral blood was required for inclusion in this study. We believe that a randomized trial comparing ECP with standard chemotherapy is urgently needed.
From St John's Institute of Dermatology (United Medical and Dental Schools of Guy's and St Thomas' Hospitals) (Drs Fraser-Andrews, Whittaker, and Russell-Jones) and Department of Public Health Medicine (UMDS) (Mr Seed), St Thomas' Hospital, London, England.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Monitoring the Decrease of Circulating Malignant T Cells in Cutaneous T-Cell Lymphoma During Photopheresis and Interferon Therapy
Ferenczi et al.
Arch Dermatol 2003;139:909-913.
ABSTRACT
| FULL TEXT
Circulating CD4+CD7- Lymphocyte Burden and Rapidity of Response: Predictors of Outcome in the Treatment of Sezary Syndrome and Erythrodermic Mycosis Fungoides With Extracorporeal Photopheresis
Stevens et al.
Arch Dermatol 2002;138:1347-1350.
ABSTRACT
| FULL TEXT
A prospective study on the evolution of the T-cell repertoire in patients with Sezary syndrome treated by extracorporeal photopheresis
Ingen-Housz-Oro et al.
Blood 2002;100:2168-2174.
ABSTRACT
| FULL TEXT
Extracorporeal photopheresis in Sezary syndrome: hematologic parameters as predictors of response
Evans et al.
Blood 2001;98:1298-1301.
ABSTRACT
| FULL TEXT
Primary Cutaneous T-Cell Lymphoma: Review and Current Concepts
Siegel et al.
JCO 2000;18:2908-2925.
ABSTRACT
| FULL TEXT
Effectiveness of Photopheresis in Sezary Syndrome
Stevens et al.
Arch Dermatol 1999;135:995-997.
FULL TEXT
Sezary Syndrome, Cutaneous T-Cell Lymphoma, and Extracorporeal Photopheresis
Edelson et al.
Arch Dermatol 1999;135:600-601.
FULL TEXT
An Update on Treating Cutaneous T-Cell Lymphoma
Journal Watch Dermatology 1999;1999:10-10.
FULL TEXT
|
