title: Improvement in peripheral blood disease burden in patients with Sézary syndrome and leukemic mycosis fungoides after total skin electron beam therapy.
abstract: BACKGROUND
  There is a paucity of effective therapies for patients with Sézary syndrome and advanced mycosis fungoides with peripheral blood involvement. Total skin electron beam (TSEB) radiation therapy is an extremely effective skin-directed therapy for these patients, but, until recently, it was thought not to signifcantly affect the peripheral blood malignant T-cell population.
  
  
  OBJECTIVE
  We conducted this study to determine if TSEB has therapeutic effect on the peripheral blood in patients with advanced mycosis fungoides and Sézary syndrome.
  
  
  METHODS
  All patients on stable medication regimens seen in our photopheresis facility who received TSEB therapy between January 2008 and October 2011 at Temple University Hospital, Philadelphia, PA, were analyzed retrospectively for improvement in the peripheral blood, as documented by flow cytometry.
  
  
  RESULTS
  Six of 11 patients achieved 50% or greater decrease in their peripheral blood malignant T-cell population after TSEB therapy, for an overall response rate of 55%. Within the group of patients who had a response in the skin, 67% also had a response in the peripheral blood.
  
  
  CONCLUSIONS
  This analysis is limited in 3 ways. First, the sample described is small. Second, the results may be confounded by the fact that each patient was on other systemic therapies in addition to TSEB, albeit stable pre-existing regimens. The time interval between completion of TSEB therapy and repetition of flow cytometry was not standardized among patients, which may result in an underestimation of the overall response to TSEB therapy.
  
  
  CONCLUSIONS
  In patients with advanced mycosis fungoides and Sézary syndrome, the peripheral blood tumor burden may improve after treatment with TSEB.
authors: Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
authors: Rachel S
authors: RS
authors: Klein
authors: James D
authors: JD
authors: Dunlop
authors: Sara S
authors: SS
authors: Samimi
authors: Kelly A
authors: KA
authors: Morrissey
authors: Katherine G
authors: KG
authors: Evans
authors: Jennifer M
authors: JM
authors: Gardner
authors: Camille E
authors: CE
authors: Introcaso
authors: Carmela C
authors: CC
authors: Vittorio
authors: Alain H
authors: AH
authors: Rook
authors: Bizhan
authors: B
authors: Micaily
authors: Ellen J
authors: EJ
authors: Kim
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018450:Disease Progression; D005434:Flow Cytometry; D006801:Humans; D018655:Lymphocyte Count; D009182:Mycosis Fungoides / Q000473:pathology* / Q000532:radiotherapy*; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D012751:Sezary Syndrome / Q000473:pathology* / Q000532:radiotherapy*; D012878:Skin Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D016896:Treatment Outcome; D047368:Tumor Burden; D014916:Whole-Body Irradiation