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Interferon alfa-2a maintenance after salvage autologous stem cell transplantation in atypical mycosis fungoides with central nervous system involvement

Doerschner, M.; Pekar-Lukacs, A.; Messerli-Odermatt, O.; Dommann-Scherrer, C.; Rütti, M.; Müller, A. M.; Nair, G.; Kamarachev, J.; Kerl, K. and Beer, M., et al. (2019) In British Journal of Dermatology
Abstract


Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma with unfavourable prognosis for patients with advanced stages of the disease. Refractory disease and advanced-stage disease require systemic therapy. We report on a rare case of an atypical predominantly CD8
+
folliculotropic MF, a subtype of MF with poorer prognosis, in a 59-year-old woman. She was initially diagnosed with MF restricted to the skin, of T3N0M0B0/stage IIB according to the current World Health Organization–European Organisation for Research and Treatment of Cancer... (More)


Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma with unfavourable prognosis for patients with advanced stages of the disease. Refractory disease and advanced-stage disease require systemic therapy. We report on a rare case of an atypical predominantly CD8
+
folliculotropic MF, a subtype of MF with poorer prognosis, in a 59-year-old woman. She was initially diagnosed with MF restricted to the skin, of T3N0M0B0/stage IIB according to the current World Health Organization–European Organisation for Research and Treatment of Cancer classification. First-line treatment with local percutaneous radiotherapy in combination with systemic interferon alfa-2a resulted in complete remission. However, 21 months later the disease progressed to T3N0M1B0/stage IVB with development of cerebral manifestation and thus very poor prognosis. Allogeneic stem cell transplantation (SCT) was not a therapeutic option due to the lack of a suitable donor. We initiated methotrexate and cytarabine chemotherapy, followed by high-dose chemotherapy with thiotepa and carmustine with autologous SCT. Despite rapid response and complete remission of the cerebral lesions, disease recurrence of the skin occurred soon after. Interestingly, readministration of interferon alfa-2a as a maintenance treatment after the salvage autologous SCT resulted in a durable complete remission during the follow-up period of currently 17 months after autologous SCT.

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British Journal of Dermatology
publisher
Wiley-Blackwell
external identifiers
  • scopus:85062542563
ISSN
0007-0963
DOI
10.1111/bjd.17535
language
English
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no
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ad9ad81c-d5d7-4084-a029-dcd509a04cb3
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2019-03-19 08:53:44
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2019-04-10 04:21:26
@article{ad9ad81c-d5d7-4084-a029-dcd509a04cb3,
  abstract     = {<p><br>
                                                         Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma with unfavourable prognosis for patients with advanced stages of the disease. Refractory disease and advanced-stage disease require systemic therapy. We report on a rare case of an atypical predominantly CD8                             <br>
                            <sup>+</sup><br>
                                                          folliculotropic MF, a subtype of MF with poorer prognosis, in a 59-year-old woman. She was initially diagnosed with MF restricted to the skin, of T3N0M0B0/stage IIB according to the current World Health Organization–European Organisation for Research and Treatment of Cancer classification. First-line treatment with local percutaneous radiotherapy in combination with systemic interferon alfa-2a resulted in complete remission. However, 21 months later the disease progressed to T3N0M1B0/stage IVB with development of cerebral manifestation and thus very poor prognosis. Allogeneic stem cell transplantation (SCT) was not a therapeutic option due to the lack of a suitable donor. We initiated methotrexate and cytarabine chemotherapy, followed by high-dose chemotherapy with thiotepa and carmustine with autologous SCT. Despite rapid response and complete remission of the cerebral lesions, disease recurrence of the skin occurred soon after. Interestingly, readministration of interferon alfa-2a as a maintenance treatment after the salvage autologous SCT resulted in a durable complete remission during the follow-up period of currently 17 months after autologous SCT.                         <br>
                        </p>},
  author       = {Doerschner, M. and Pekar-Lukacs, A. and Messerli-Odermatt, O. and Dommann-Scherrer, C. and Rütti, M. and Müller, A. M. and Nair, G. and Kamarachev, J. and Kerl, K. and Beer, M. and Messerli, M. and Frauenknecht, K. and Haralambieva, E. and Hoetzenecker, W. and French, L. E. and Guenova, E.},
  issn         = {0007-0963},
  language     = {eng},
  publisher    = {Wiley-Blackwell},
  series       = {British Journal of Dermatology},
  title        = {Interferon alfa-2a maintenance after salvage autologous stem cell transplantation in atypical mycosis fungoides with central nervous system involvement},
  url          = {http://dx.doi.org/10.1111/bjd.17535},
  year         = {2019},
}