title: Long-term follow-up and survival of cutaneous T-cell lymphoma patients treated with extracorporeal photopheresis.
abstract: OBJECTIVE
  Extracorporeal photopheresis (ECP) is effective for treating cutaneous T-cell lymphoma. In 1987, a pivotal trial showed 81% overall response rate (ORR) using outdated criteria. No long-term follow-up was available for assessing survival. This study applies modern criteria to the 1987 trial to assess the impact of ECP on skin responses and also updates overall survival of the cohort.
  
  
  METHODS
  Generalized erythroderma (GE, stage T4, n = 31) or extensive patch-plaque (EPP, stage T2, n = 8) patients received ECP (mean 3.9 years' duration). Patients achieving ≥ 50% partial skin response, ≥ 90% near-complete skin response, treatments required, and duration of response (DOR) were determined. Overall survival (OS) from diagnosis and first ECP treatment was determined for all patients and the GE cohort.
  
  
  RESULTS
  Patients showed 74% skin ORR using modern criteria; 33% of patients achieved ≥ 50% partial skin response (after median 7.1 months, mean 23 ECP treatments); 41% achieved ≥ 90% improvement (after median 19.6 months, mean 40 ECP treatments). Mean DOR was 14 months for ≥ 50% improvement and 8.9 months for ≥ 90% improvement. Response rates were comparable for GE and EPP cohorts. Median OS was 9.2 years from diagnosis and 6.6 years from ECP initiation (71.6 months follow-up).
  
  
  CONCLUSIONS
  Analysis of long-term follow-up confirmed durable responses and prolonged survival of patients treated with ECP.
authors.affiliation: Department of Dermatology, Medical University of Vienna, Vienna, Austria. robert.knobler@meduniwien.ac.at
authors.forename: Robert
authors.initials: R
authors.lastname: Knobler
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
authors.forename: Christiane
authors.initials: C
authors.lastname: Querfeld
authors.forename: David
authors.initials: D
authors.lastname: Straus
authors.forename: Steven
authors.initials: S
authors.lastname: Horwitz
authors.forename: Jasmine
authors.initials: J
authors.lastname: Zain
authors.forename: Francine
authors.initials: F
authors.lastname: Foss
authors.forename: Timothy
authors.initials: T
authors.lastname: Kuzel
authors.forename: Kim
authors.initials: K
authors.lastname: Campbell
authors.forename: Larisa
authors.initials: L
authors.lastname: Geskin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D012878:Skin Neoplasms / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate; D013997:Time Factors