PHOTOPHERESIS THERAPY FOR CUTANEOUS T-CELL LYMPHOMA

Background: Cutaneous T-cell lymphoma is a chronic peripheral lymphoma in which aggressive combined therapy elicits high response rates but does not improve survival. Photopheresis therapy has reportedly induce d remissions and prolonged survival in patients with advanced disease. Objective: We studied all patients who began photopheresis treatment between February 1988 and July 1994 to determine whether we could conf irm the remission rates of previous studies, to evaluate variables tha t might predict a response, and to discover whether an accelerated del ivery system would improve the remission rate or response time. Method s: After an oral dose of methoxsalen was administered, a leukocyte-enh anced quantity of blood was exposed to UVA radiation for 1.5 hours and returned to the patient. With our accelerated system 6 x 10(9) cells were irradiated in nine cycles. Treatments were given on 2 consecutive days once a month. Results: Among 34 patients whose results could be evaluated, the overall response rate (complete and partial remissions) was 50%; most patients had mild side effects. All responders except o ne had erythroderma. Responders had a decrease of 75% in mean skin sco res, whereas nonresponders had an increase of 21%. Conclusion: Photoph eresis appears to be effective for selected patients with erythrodermi c cutaneous T-cell lymphoma, although we did not achieve as high a rem ission rate as previously reported by others.