LONG-TERM FOLLOW-UP OF PATIENTS WITH CUTANEOUS T-CELL LYMPHOMA TREATED WITH EXTRACORPOREAL PHOTOCHEMOTHERAPY

Background: Few studies have assessed the long-term outcome of patient s with cutaneous T-cell lymphoma (CTCL) treated with extracorporeal ph otochemotherapy (ECP). Objective: Our objective was to assess the effi cacy, safety, and survival of a cohort of patients with refractory T-c ell lymphoma in various stages of cutaneous involvement who were treat ed with ECP. Methods: Twenty patients who had received at least 6 mont hs of ECP between September 1988 and April 1991 were reevaluated and t he data analyzed statistically to obtain outcome data through December 1995. Results: A complete response (disappearance of all lesions) was obtained in five patients (25%) and a partial response (disappearance of at least 50% of lesions) in five patients (25%). Of the 10 respond ers, seven (70%) were weaned from ECP. Two of seven patients had a rel apse. Ten patients (50%) showed no response to ECP. No statistically s ignificant differences between responders and nonresponders were found with respect to demographic, clinical, or laboratory variables. Seven patients died of causes directly related to CTCL and two patients die d of unrelated causes. Median survival time for the entire cohort was 96 months (range, 16 to 152 months). An assessment of early response a fter 6 to 8 months of ECP had a sensitivity of 100% and a specificity of 90% for predicting long-term (> 4 years) outcome, Adverse effects w ere minimal. Conclusion: ECP is a safe effective alternative therapy f or CTCL that is refractory to other therapies; it can induce a long-te rm, disease-free remission in a minority of patients. Response in the first 6 to 8 months of treatment predicts long-term outcome.