Effect of insulin-dependent diabetes mellitus on response to extracorporeal photopheresis in patients with Sézary syndrome.
BACKGROUND
Extracorporeal photopheresis (ECP) has become a primary therapy for selected forms of cutaneous T-cell lymphoma, especially Sézary syndrome. Variability in response of patients with Sézary syndrome to ECP has been reported.


OBJECTIVE
Our purpose was to determine whether underlying medical conditions influence the efficacy of ECP in patients with Sézary syndrome.


METHODS
We retrospectively reviewed the medical records of 55 patients with Sézary syndrome who received ECP between 1987 and 2000. Efficacy criteria included decrease in Sézary cell count, erythroderma, lymphadenopathy, organomegaly, and pruritus.


RESULTS
Thirty-four patients responded well and 10 patients responded partially to ECP; 11 patients had no response. Nine patients with no response to ECP had insulin-dependent diabetes mellitus (IDDM). IDDM was documented in only 2 patients with a good response and in no patients with a partial response to ECP.


CONCLUSIONS
Patients with Sézary syndrome and IDDM typically respond poorly to the standard ECP treatment regimen.
Bouwhuis
Saskia A
SA
Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
el-Azhary
Rokea A
RA
Gibson
Lawrence E
LE
McEvoy
Marian T
MT
Pittelkow
Mark R
MR
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017893:Photopheresis / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012751:Sezary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome