ReportExtracorporeal photopheresis for the treatment of Sézary syndrome using a novel treatment protocol
Section snippets
Study design
A single-center retrospective cohort analysis was performed of patients with SS who received a minimum of 2 months of ECP at our center between 2002 and 2007. Medical records of each patient were reviewed. A number of clinical, hematologic, and immunologic parameters were monitored during treatment and correlated with clinical outcome. Baseline variables were also recorded to identify any predictors of a favorable response to ECP.
Patient selection criteria
Patients were eligible for inclusion in this analysis if they
Patient characteristics
Thirteen patients, 7 female and 6 male, were analyzed in this study. Two further patients who discontinued photopheresis before 2 months of treatment were not studied; these patients ceased because of poor venous access and a concurrent diagnosis of lung carcinoma, respectively. Photopheresis was administered to 9 of the 13 patients by heparinized peripheral access lines and 4 patients required arteriovenous fistulae formation to continue with long-term treatment.
The median age at the start of
Responses
Overall, 8 patients (62%) responded to ECP. Two patients achieved complete response (1 patient achieved CCR and the second achieved CCR and complete hematologic response) and 6 patients achieved a partial response. Five patients did not respond to photopheresis: 3 patients maintained stable disease, and two patients had progressive disease. At a median follow-up of living patients of 27.5 months (range 8-115 months), the median OS has not been reached (Fig 1). The 2- and 4-year predicted OS is
Discussion
ECP induces clinical and symptomatic responses in patients with erythrodermic CTCL,7 but response rates of previous studies vary considerably. In this study of 13 patients with SS, 8 patients responded to photopheresis. Our OR rate of 62% is lower than the previously reported OR rate of 83% in erythrodermic CTCL reported by Edelson et al7 and 83% in SS reported by Gottlieb et al.12 Our OR rate is, however, comparable with more recent studies, such as by Evans et al21 (57% OR rate) and
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Conflicts of interest: None declared.