TREATMENT OF MYCOSIS-FUNGOIDES WITH PHOTOCHEMOTHERAPY (PUVA) - LONG-TERM FOLLOW-UP

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.