Novel treatment approaches for cutaneous T-cell lymphoma

  • Francine M. Foss
  • Timothy M. Kuzel
Part of the Cancer Treatment and Research book series (CTAR, volume 99)


A number of efficacious therapeutic approaches to the various stages of mycosis fungoides (MF) and the Sezary syndrome (SS) are available. Considerable controversy exists, however, regarding the curability of this indolent disease process with currently described modalities. The lack of convincing survival benefit to patients in randomized trials of aggressive multimodality therapy compared with palliative treatments suggests that long disease-free remissions may be observed after therapy but reflect disease biology rather than inherent curative potential of the modality applied [1].


Clin Oncol Mycosis Fungoides Diphtheria Toxin Murine Monoclonal Antibody Sezary Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kaye FJ, Bunn PA Jr, Steinberg SM, Stocker JL, Ihde DC, Fischmann AB, Glatstein EJ, Schechler GP, Phelps RM, Foss FH and Sausvile EA. A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides. N Engl J Med 321:1784–1790, 1989.PubMedCrossRefGoogle Scholar
  2. 2.
    Dicken CH. Retinoids: a review. J Am Acad Dermatol 11:541–552, 1984.PubMedGoogle Scholar
  3. 3.
    Fulton RA, Souteyrand P, Thivolet J. Influence of retinoid Ro 10-9359 on cell-mediated immunity in vivo. Dermatologica 165:568–572, 1982.PubMedCrossRefGoogle Scholar
  4. 4.
    Kessler JF, Jones SE, Levine N, Lynch PJ, Booth AR, Meyskens FL Jr. Isotretinoin and cutaneous helper T-cell lymphoma (mycosis fungoides). Arch Dermatol 123:201–204, 1987.PubMedCrossRefGoogle Scholar
  5. 5.
    Molin L, Thomsen K, Volden G. 13-cis-retinoic acid in mycosis fungoides: a report from the Scandinavian mycosis fungoides study group. In Saurat JH (ed), Retinoids: New Trends in Research and Therapy: Retinoid Symposium, Geneva, 1984. S Karger AG: New York, p 341–345, 1985.Google Scholar
  6. 6.
    Warrell RP Jr, Coonley CJ, Kempin SJ, Myskowski P, Safai B, Itri LH. Isotretinoin in cutaneous T-cell lymphoma. Lancet 2(8350):629, 1983.PubMedCrossRefGoogle Scholar
  7. 7.
    Claudy AL, Delonnier Y, Hermier C. Treatment of cutaneous T-cell lymphoma with a new aromatic-retinoid (Ro-10-9359). Arch Dermatol Res 273:37, 1982.PubMedCrossRefGoogle Scholar
  8. 8.
    Souteyrand P, Thivolet J, Fulton R. Treatment of parapsoriasis en plaques and mycosis fungoides with an oral aromatic retinoid (Ro 10-9359). In Orfanos CE (ed), Retinoids. Advances in Basic Research and Therapy. Springer: Berlin, pp 313–314, 1981.Google Scholar
  9. 9.
    Claudy AL, Rouchouse B. Treatment of cutaneous T-cell lymphomas with retinoids. In: Saurat JH (ed), Retinoids: New Trends in Research and Therapy: Retinoid Symposium, Geneva, 1984. S Karger AG: New York, pp 335–341, 1985.Google Scholar
  10. 10.
    Kuzel TM, Roenigk HH Jr, Samuelson E, Rosen S. The treatment of mycosis fungoides with all-trans retinoic acid. Blood 82(10):2264a, 1993.Google Scholar
  11. 11.
    Braathen LS, McFadden N. Successful treatment of mycosis fungoides with the combination of etretinate and human recombinant interferon alfa-2a. J Dermatol Treatment 1:29–35, 1989.Google Scholar
  12. 12.
    Dreno B, Claudy A, Meynadier J, Verret JL, Souteyrand P, Ortonne JP, Ralis B, Godefroy WY, Beerglack K, Thill L, Kokoschka EM, Miksche M. The treatment of 45 patients with cutaneous T-cell lymphoma with low doses of interferon-alfa 2a and etretinate. Br J Dermatol 125:456–459, 1991.PubMedCrossRefGoogle Scholar
  13. 13.
    Knobler RM, Trautinger F, Radaszkiewicz T, Ko Koschka EM, Mick Sche M. Treatment of cutaneous T-cell lymphoma with a combination of low-dose interferon alfa-2b and retinoids. J Am Acad Dermatol 24:247–252, 1991.PubMedCrossRefGoogle Scholar
  14. 14.
    Thomsen K, Hammar H, Molin L, Volden G. Retinoids plus PUVA (RePUVA) and PUVA in mycosis fungoides, plaque stage. Acta Derm Venereol 69:536–538, 1989.PubMedGoogle Scholar
  15. 15.
    Nagatani T, Kin ST, Baba N, Miyamoto H, Nakajima H. A case of cutaneous T-cell lymphoma treated with recombinant interleukin-2. Acta Derm Venereol 68:504–508, 1988.PubMedGoogle Scholar
  16. 16.
    Rybojad M, Marolleau JP, Flageul B, Baccard M, Brandely M, Morel P, Gisselbrecht C. Successful interleukin-2 therapy of advanced cutaneous T-cell lymphoma. Br J Dermatol 127(1):63, 1992. (letter)PubMedCrossRefGoogle Scholar
  17. 17.
    Grever MR, Bisaccia E, Scarborough DA, Metz EN, Neidhart JA. An investigation of 2’-deoxycoformycin in the treatment of cutaneous T-cell lymphoma. Blood 61:279–282, 1983.PubMedGoogle Scholar
  18. 18.
    Cummings FJ, Kim K, Neiman RS, Gonis RL, Oken M, Weitzman S, Mann RB, O’Connell MJ. Phase II trial of pentostatin in refractory lymphomas and cutaneous T-cell disease. J Clin Oncol 9(4):565–571, 1991.PubMedGoogle Scholar
  19. 19.
    Foss F, Breneman D, Ihde D, Phelps RM, Fischmann AB, Schecter GP, Linnoila I, Breneman JC, Cotelingam JD, Ghosh BC, Steinberg SM, Lynch JW, Phares JC, Stocker JL, Bastian A, Sausville EA. Phase II study of pentostatin and intermittent high dose recombinant interferon alfa-2A in advanced mycosis fungoides/Sezary syndrome. J Clin Oncol 10(12):1907–1913, 1992.PubMedGoogle Scholar
  20. 20.
    Von Hoff D, Dahlberg S, Hartstock R, Eyre HJ. Activity of fludarabine monophosphate in patients with advanced mycoiss fungoides: a Southwest Oncology Group Study. J Nat Cancer Inst 82(16):1353–1355, 1990.CrossRefGoogle Scholar
  21. 21.
    Foss F, Ihde D, Linnoila I, Fischman AB, Schechter GP, Cotelingam JD, Steinberg SM, Ghosh BC, Stocker JL, Bastian A, Phares JC, Sausville EA. Phase II trial of fludarabine phosphate and interferon alfa-2A in advanced mycosis fungoides/Sezary syndrome. J Clin Oncol 12(10):2051–2059, 1994.PubMedGoogle Scholar
  22. 22.
    Cheson B, Sorenson J, Foss F, Vena DA. Neurotoxicity of purine analogs: a review. J Clin Oncol 12(10):2216–2228, 1994.PubMedGoogle Scholar
  23. 23.
    Saven A, Carrera CJ, Carson DA, Beutler E, Piro LD. 2-Chlorodeoxyadenosine: an active agent in the treatment of cutaneous T-cell lymphoma. Blood 80(3):587, 1992.PubMedGoogle Scholar
  24. 24.
    Lee E, Kuzel T, Samuelson E, Huria A, Tallman MS, Roenigk HH Jr, Rademaker AW, Rosen S. Phase II trial of 2-chlorodeoxyadeonsine for the treatment of cutaneous T-cell lymphoma. Blood 87(3):906–911, 1996.Google Scholar
  25. 25.
    O’Brien S, Kurzrock R, Duvic M, Kantarjian H, Stuss S, Robertson LE, Estey E, Pierce S, Keating HJ. 2-Clorodeoxyadenosine therapy in patients with T-cell lymphoproliferative disorders. Blood 84(3):733–738, 1994.PubMedGoogle Scholar
  26. 26.
    Betticher DC, Fey MF, von Rohr A, Tobler A, Jenzer H, Gratwohl A, Lohri A, Pugin P, Hess U, Pagani O, Zulian G, Cerney T. High incidence of infections after 2-chlorodeoxyadenosine (2-CDA) therapy in patients with malignant lymphomas and chronic and acute leukemias. Ann Oncol 5:57–64, 1994.PubMedGoogle Scholar
  27. 27.
    Dillman RO, Shawler DL, Dillman JB, Royston I. Therapy of chronic lymphocytic leukemia and cutaneous T-cell lymphoma with T-101 monoclonal antibody. J Clin Oncol 2:881–891, 1984.PubMedGoogle Scholar
  28. 28.
    Dillman RO, Beauregard J, Shawler DL, Halpern SE, Markman M, Ryan KP, Baird SM, Clutter M. Continuous infusion of T-101 monoclonal antibody in chronic lymphocytic leukemia and cutaneous T-cell lymphoma. J Biol Response Mod 5:394–410, 1986.PubMedGoogle Scholar
  29. 29.
    Rosen ST, Zimmer AM, Goldman-Leiken R, Gordon LI, Kazikiewicz JM, Kaplan EH, Varikoijas D, Marder RM, Dykewicz MS, Piergies A. Radioimmunodetection andradioimmunotherapy of cutaneous T-cell lymphomas using an 131I-labeled monoclonal antibody: an Illinois Cancer council study. J Clin Oncol 5:562–573, 1987.PubMedGoogle Scholar
  30. 30.
    Waldmann TA. The I1-2/IL-2 receptor system: a target for rational immune intervention. Trends Pharmacol Sci 14:159–164, 1993.PubMedCrossRefGoogle Scholar
  31. 31.
    LeMaistre CF, Rosen ST, Frankel A, Kornfeld S, Saria E, Meneghtetti C, Drajesk J, Fishwild D, Scannon P, Byers V. Phase I trial of H-65-RTA immunoconjugate in patients with cutaneous T-cell lymphoma. Blood 78:1173–1182, 1991.PubMedGoogle Scholar
  32. 32.
    Foon KA, Oseroff AR, Vaic Kus L, Greenberg SJ, Russell D, Bernstein Z, Pincus S, Kohler, Seon BK, Tahaogl E, Beers T, Chakraborty M, Bhatachavya-Chatterjee M. Immune responses in patients with T-cell lymphoma treated with an anti-idiotype antibody mimicking a highly restricted T-cell antigen. Clin Cancer Res 1:1285–1294, 1995.PubMedGoogle Scholar
  33. 33.
    Bacha PA, Forte SE, McCarthy DM, Estis L, Yamada G, Nichols JC. Impact of interleukin-2 receptor targeted cytotoxins on a unique model of murine interleukin-2 receptor expressing malignancy. Int J Cancer 49:96–101, 1991.PubMedCrossRefGoogle Scholar
  34. 34.
    Bacha P, Williams D, Waters C, Wiliams JM, Murphy JR, Strom TB. Interleukin-2 receptor mediated action of a diphtheria toxin related interleukin-2 fusion protein. J Exp Med 167:612–622, 1988.PubMedCrossRefGoogle Scholar
  35. 35.
    Williams D, Parker K, Bacha P, Bishai W, Borowski M, Genbauffe F, Strom TB, Murphy JR. Diphtheria toxin receptor binding domain substitution with interleukin-2: genetic reconstruction and properties of a diphtheria toxin related interleukin-2 fusion protein. Protein Eng 1:493–498, 1987.PubMedCrossRefGoogle Scholar
  36. 36.
    Williams D, Synder C, Strom T, Murphy J. Structure/function analysis of interleukin-2 toxin (DAB486IL2). J Biol Chem 285:11885–11889, 1990.Google Scholar
  37. 37.
    LeMaistre CF, Meneghetti C, Rosenblum M, Reuben J, Parker K, Shaw J, Diesseroth A, Woodworth T, Parkinson D. Phase I trial of an interleukin-2 fusion toxin (DAB 486IL2) in hematologic malignancies expressing the IL-2 receptor. Blood 79(10):2547–2554, 1992.PubMedGoogle Scholar
  38. 38.
    LeMaistre CF, Craig F, Meneghetti C, McMullin B, Parker K, Reuben J, Boldt DH, Rosenblum M, Woodworth T. Phase I trial of a 90-minute infusion of the fusion toxin DAB(486)IL2 in hematologic cancers. Cancer Res 53(17):3930–3934, 1993.PubMedGoogle Scholar
  39. 39.
    Hesketh P, Caguioa P, Koh H, Dewey H, Facada A, McCaffrey R, Parker K, Nylen P, Woodworth T. Clinical activity of a cytotoxic fusion protein in the treatment of cutaneous T-cell lymphoma. J Clin Oncol ll(9):1682–1690, 1993.Google Scholar
  40. 40.
    Kuzel TM, Rosen ST, Gordon LI, Winter J, Samuelson E, Kaul K, Roenigk HH Jr, Nylen P, Woodworth T. Phase I trial of the Diphtheria toxin/interleukin-2 fusion protein DAB486IL-2: efficacy in mycosis fungoides and other non-Hodgkin’s lymphomas. Leuk Lymphoma 11:369–377, 1993.PubMedCrossRefGoogle Scholar
  41. 41.
    Foss F, Borkowski T, Gilliom M. Chimeric fusion protein toxin DAB(486)IL2 in refractory mycosis fungoides and the Sezary syndrome: correlation of activity and IL2 receptor expression in a phase II study. Blood 84(6):1765–1774, 1994.PubMedGoogle Scholar
  42. 42.
    LeMaistre C, Kuzel T, Foss F, Hesketh P, Saleh M, Platanias L, Schwartz G, Craig F, Toison K, Woodworth T. DAB389IL2 is well tolerated at doses inducing responses in IL2R expressing lymphomas. Blood 83(Suppl l):137a, 1993. (abstract)Google Scholar
  43. 43.
    Kuzel TM, Foss F, LeMaistre CF, Platanias L, Ratain M, Rook A, Saleh M, Schwartz G, Nichols J. Phase I trial of diphtheria toxin fusion protein (DAB389IL-2) for the treatment of interleukin-2 receptor expressing hematologic neoplasms. Blood 86(Suppl l):274a, 1995. (abstract)Google Scholar
  44. 44.
    Dalloul A, Laroche L, Bagot M, Mossalayi MD, Fourcade C, Thacker DJ, Hogge DE, Merle-Beral H, DeGre P, Schmitt C. Interleukin-7 is a growth factor for Sezary lymphoma cells. J Clin Invest 90(3):1054–1060, 1992.PubMedGoogle Scholar
  45. 45.
    Foss F, Koc Y, Stetler-Stevenson MA, Nguyen DT, O’Brien MC, Turner R, Sausville EA. Costimulation of cutaneous T-cell lymphoma cells by interleukin-7 and interleukin-2: potential autocrine or paracrine effectors in the Sezary syndrome. J Clin Oncol 12(2):326–335, 1994.PubMedGoogle Scholar
  46. 46.
    Przybilla B, Burg G, Schmoeckel C, Braun-Falco O. Treatment of cutaneous T-cell lymphomas with TP-5. Acta Derm Venereol (Stockh) 63:524–529, 1983.Google Scholar
  47. 47.
    Bernengo M, Appino A, Bertero M, Novelli M, Fierro MT, Doveil GC, Lisa F. Thymopentin in Sezary Syndrome. J Natl Cancer Inst 84(17):1341–1346, 1992.PubMedCrossRefGoogle Scholar
  48. 48.
    Foss F, Sznol M, Urba W, Kopp W, Duffy P, McCaffrey R, Hesketh P, Longo D. Biological activity of thymopentin in cutaneous T-cell lymphoma. Proc AACR, 1994.Google Scholar
  49. 49.
    Smalley RV, Andersen JW, Hawkins MJ, Bhide V, O’Connell MJ, Oken MM, Borden EC. Interferon alfa combined with cytotoxic chemotherapy for patients with B-cell non-Hodgkin’s lymphoma. N Engl J Med 327:1336–1341, 1992.PubMedCrossRefGoogle Scholar
  50. 50.
    Alexanaian R, Dimopoulos M. The treatment of multiple myeloma. N Engl J Med 330:484–489, 1994.CrossRefGoogle Scholar
  51. 51.
    Kuzel TM, Roenigk HH Jr, Samuelson E, Herrmann JJ, Hurria A, Rademaker AW, Rosen ST. Effectiveness of interferon alfa-2a combined with phototherapy for Mycosis Fungoides and the Sezary Syndrome. J Clin Oncol 13:257–263, 1995.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers, Boston 1999

Authors and Affiliations

  • Francine M. Foss
  • Timothy M. Kuzel

There are no affiliations available

Personalised recommendations