title: Multicenter photopheresis intervention trial in early-stage mycosis fungoides.
abstract: OBJECTIVE
  To demonstrate the efficacy of the UVAR XTS Photopheresis System and evaluate health-related quality of life in patients with early-stage mycosis fungoides (MF).
  
  
  METHODS
  Extracorporeal photopheresis was administered 2 days every 4 weeks for 6 months. Patients with partial responses by skin weighted assessment continued for 6 months; nonresponders added oral bexarotene and/or interferon α. Health-related quality of life was assessed at baseline and every 3 months with 3 validated tools.
  
  
  RESULTS
  Nineteen patients with early-stage MF (7 men, 12 women; 16 white, 3 African Americans) with median age of 63.5 years (range, 46-85 years) participated. Their stages were IA (n = 3), IB (n = 14), and IIA (n = 2). The overall response rate for extracorporeal photopheresis (ECP) alone, was 42% (8/19; including 7 partial response, 1 complete response), with a median of 12 ECP sessions (range, 3-32) given over a median of 12 months (3-32 months) and with an overall duration of response of 6.5 months (range, 1-48 months). Seven patients with stable disease at 3 months received additional bexarotene (3/5; 1 complete response) or bexarotene plus interferon α (1/2), and 4 (57%) of 7 responded. Treatment-related adverse effects were limited to those expected with interferon (fatigue, nausea, vomiting, and diarrhea), or with hypertriglyceridemia and bexarotene. Trends in health-related quality of life indicated an improvement in emotional scores over time.
  
  
  CONCLUSIONS
  ECP is effective for patients with early-stage MF alone or in combination with biologic response modifiers with low toxicity and improved quality of life.
authors.affiliation: Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX 77030-4095, USA.
authors.forename: Rakhshandra
authors.initials: R
authors.lastname: Talpur
authors.forename: Marie Francis
authors.initials: MF
authors.lastname: Demierre
authors.forename: Larisa
authors.initials: L
authors.lastname: Geskin
authors.forename: Elma
authors.initials: E
authors.lastname: Baron
authors.forename: Silvina
authors.initials: S
authors.lastname: Pugliese
authors.forename: Kelley
authors.initials: K
authors.lastname: Eubank
authors.forename: John A
authors.initials: JA
authors.lastname: Zic
authors.forename: Donald R
authors.initials: DR
authors.lastname: Miller
authors.forename: Michael
authors.initials: M
authors.lastname: Tharp
authors.forename: Kimberly
authors.initials: K
authors.lastname: Bohjanen
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000077610:Bexarotene; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D017893:Photopheresis; D011788:Quality of Life; D013601:T-Lymphocytes / Q000276:immunology; D013764:Tetrahydronaphthalenes / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016898:Interferon-alpha; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene