Jj. Herrmann et al., TREATMENT OF MYCOSIS-FUNGOIDES WITH PHOTOCHEMOTHERAPY (PUVA) - LONG-TERM FOLLOW-UP, Journal of the American Academy of Dermatology, 33(2), 1995, pp. 234-242
Background: Mycosis fungoides (MF) is a non-Hodgkin's T-cell lymphoma
of the skin that often begins as Limited patches and plaques with slow
progression to systemic involvement. No studies have been published c
omparing photochemotherapy (PUVA) with ether topical therapies in the
treatment of early-stage disease. Objective: The purpose of the study
was to examine our long-term experience using PUVA to treat early-stag
e MF and to compare its effectiveness and side-effect profile with oth
er previously reported topical therapies. Methods: Eighty-two patients
with MF (83% stage IA or IB) were treated with PUVA. Clinical and his
tologic features were observed for a period from 2 months to 15 years
(median, 43 months). Results: A response was noted in 78 patients (95%
) with complete clinical and histologic clearing in 53 patients (65%)
for all stages. The mean duration of total complete response to PUVA f
or all stages was 43 months (3.6 years). The mean survival of our stud
y group for all stages was 8.5 years. Signs of chronic actinic skin da
mage were found in 10% of patients, including three patients with basa
l cell carcinomas and three patients with squamous cell carcinomas. In
a nonrandomized comparison with previously reported data for other to
pical therapies, the efficacy and side-effect profile of PUVA compared
favorably. Conclusion: PUVA is an effective and safe therapy for MF w
ith prolonged disease-free remissions being achieved. Patients with st
age I and II MF respond best to PUVA. Palliative therapy with PUVA is
useful in more advanced cases of MF.