Original articlePhotodynamic therapy with methyl-aminolevulinic acid for paucilesional mycosis fungoides: A prospective open study and review of the literature
Section snippets
Patient eligibility criteria
The prospective study was conducted in the Skin Cancer Unit at Nantes University Hospital, France, between 2009 and 2012. Patients included were older than 18 years, with a histologically proven stage-I MF (International Society for Cutaneous Lymphoma [ISCL]/European Organization for Research and Treatment of Cancer [EORTC] revised TNM)11 and paucilesional (no more than 5 lesions).
The ethics committee of Nantes (Pays de la Loire) approved the protocol and written informed consent was obtained
Results
Baseline patient and disease characteristics are summarized in Table I. Twelve patients (5 men and 7 women) with a median age of 69 years (43-82) were included.
Their lymphoma was diagnosed on average for 9 years. Half of the patients had a stage IA and the other half a stage IB. All patients (except 1) had been pretreated before PDT: they had initially received a mean of 2.4 topical treatments that included local chemotherapy. Of patients, 58% had received at least 1 prior systemic treatment (
Discussion
The primary objective of this study was to prospectively assess the response rate obtained with PDT in stage IA or IB MF lesions using a standardized procedure. An objective response in target lesions was obtained in 75% of patients, confirming the efficacy of PDT in early-stage MF. No association was observed between the response rate and the lesion type, the age, or sex of the patient. Furthermore, there was dissociation between the clinical and histologic responses. Indeed, only a partial
References (30)
- et al.
WHO-EORTC classification for cutaneous lymphomas
Blood
(2005) - et al.
Prognosis in cutaneous T-cell lymphoma by skin stage: long-term survival in 489 patients
J Am Acad Dermatol
(1999) - et al.
Management of cutaneous T-cell lymphomas: recommendations of the French cutaneous lymphoma group
Ann Dermatol Venereol
(2010) - et al.
Plaque-phase mycosis fungoides treated with photodynamic therapy: results from 12 patients
Actas Dermosifiliogr
(2010) - et al.
Revisions to the staging and classification of mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCLT) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)
Blood
(2007) - et al.
Topical photodynamic therapy for patients with therapy-resistant lesions of cutaneous T-cell lymphoma
J Am Acad Dermatol
(2004) - et al.
Photodynamic therapy for mycosis fungoides after topical photosensitization with 5-aminolevulinic acid
J Am Acad Dermatol
(1995) - et al.
Photodynamic therapy for mycosis fungoides after topical photosensitization with 5-aminolevulinic acid
J Am Acad Dermatol
(1994) - et al.
Selective distribution of porphyrins in skin thick basal cell carcinoma after topical application of methyl 5-aminolevulinate
J Photochem Photobiol B
(2001) - et al.
A review of human carcinogens–part D: radiation
Lancet Oncol
(2009)
Long-term outcome of 525 patients with mycosis fungoides and Sézary syndrome: clinical prognostic factors and risk for disease progression
Arch Dermatol
Cutaneous T-cell lymphoma: 2011 update on diagnosis, risk-stratification, and management
Am J Hematol
Joint British Association of Dermatologists and UK Cutaneous Lymphoma Group guidelines for the management of primary cutaneous T-cell lymphomas
Br J Dermatol
Photodynamic therapy with methyl-aminolevulinic acid for mycosis fungoides
Acta Derm Venereol
Photodynamic therapy with methylaminolevulinate as a valuable treatment option for unilesional cutaneous T-cell lymphoma
Photodermatol Photoimmunol Photomed
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2017, Photodiagnosis and Photodynamic TherapyCitation Excerpt :Two types of photosensitizer are commonly used: 5- aminolevulinic acid (ALA) and methyl aminolevulinate (MAL). Case reports and case-series on MF patients treated with PDT have been described, with rather promising results [6–12]. Here we report a single-Institution experience on four MF patients.
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Funding sources: None.
Conflicts of interest: None declared.