Cutaneous T-cell lymphoma: clinicopathological relationships, therapy and survival in ninety-two patients

Abstract

Clinicopathological findings, methods of treatment and survival in 92 patients with cutaneous T-cell lymphoma (CTCL) (85 mycosis fungoides and 7 Sezary syndrome), seen in the Leiden University Hospital [Leiden, The Netherlands] between 1974-1980, are reported. All patients were staged and treatment was given accordingly. Patients without signs of extracutaneous disease (74%) were treated with either total-skin electron-beam iradiation (E beam), topical mechlorethamine (HN2) or PUVA [long-wave UV + 8-methoxypsoralen]. Topical HN2 and E beam had an equal effect on survival. E-beam induced a higher number of initial complete remissions than HN2, but fewer patients relapsed while on maintenance treatment with HN2. In the patients with lymph node and/or visceral involvement, E beam followed by systemic chemotherapy, cyclophosphamide, vincristine (Oncovin) and prednisone (COP), gave better results than topical therapy or COP alone. Survival was influenced most by the type of skin lesion, the presence or absence of lymph node and/or visceral involvement and the ability to induce a complete remission initially.