title: Therapeutic advances in biological response modifiers in the treatment of cutaneous T-cell lymphoma.
abstract: Cutaneous T-cell lymphoma (CTCL) is most often a skin-infiltrating malignancy of clonal CD4+ T-cells. Therapy is based on staging and the likelihood of progression. Biological response modifiers and chemotherapeutic agents are used to preserve the integrity of the host antitumour response while selectively targeting the malignant cells. The biological response-modifying treatment options currently used to treat CTCL are bexarotene, denileukin diftitox, interferon-alpha, interferon-gamma and interleukin-12, as well as extracorporeal photopheresis and phototherapy. A combination therapy approach maximises response in patients with advanced CTCL. Biological response modifiers in combination with photopheresis are used for patients with the leukaemic phase of the disease. Among the majority of patients with advanced stage disease so treated, immune response augmentation appears to prolong survival. Future areas of research should assess not only survival and optimal treatment combinations, but also quality of life during the treatment period.
authors.affiliation: Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Vittorio
authors.forename: A H
authors.initials: AH
authors.lastname: Rook
authors.forename: L E
authors.initials: LE
authors.lastname: French
authors.forename: M
authors.initials: M
authors.lastname: Shapiro
authors.forename: M S
authors.initials: MS
authors.lastname: Lehrer
authors.forename: J M
authors.initials: JM
authors.lastname: Junkins-Hopkins
mesh_terms: D000077610:Bexarotene; D004167:Diphtheria Toxin; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000627:therapeutic use; D018664:Interleukin-12 / Q000627:therapeutic use; D007376:Interleukin-2; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy*; D017893:Photopheresis; D010789:Phototherapy; D011506:Proteins / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use
chemical_list: D004167:Diphtheria Toxin; D007155:Immunologic Factors; D016898:Interferon-alpha; D007376:Interleukin-2; D011506:Proteins; D011993:Recombinant Fusion Proteins; D013764:Tetrahydronaphthalenes; D018664:Interleukin-12; C078456:denileukin diftitox; D000077610:Bexarotene