isotretinoin and Sezary-Syndrome

Thirty-nine patients with mycosis fungoides in various stages or Sézary syndrome were treated with isotretinoin and 29 with etretinate as single drug therapy. Complete remission within 2 months was obtained with isotretinoin in 8 cases (21%) and partial remission in another 15 cases (38%). Etretinate induced complete remission in 5 cases (21%) and partial remission in 11 (46%). Only 1 case with Sézary syndrome went into partial remission. The first sign of remission occurred in 2 to 4 weeks. During continued treatment remissions could not always be maintained. Isotretinoin and etretinate were considered to be of equal potency in the treatment of mycosis fungoides.

Topics: Drug Eruptions; Etretinate; Humans; Isotretinoin; Lymphatic Metastasis; Mycosis Fungoides; Remission Induction; Sezary Syndrome; Skin Neoplasms; Tretinoin

Cutaneous T-cell lymphoma (CTCL) may respond to many therapies, but long-term disease-free survival is uncommon. Patients with advanced disease have a median survival of approximately 3 years.. Our purpose was to combine known effective agents sequentially to determine whether we could achieve remission in more patients or for longer duration.. Patients with mycosis fungoides (n = 23) or Sézary syndrome (n = 5) were treated with 4 months of recombinant interferon alfa together with isotretinoin, followed by total skin electron beam therapy alone (for stage I to II disease) or preceded by chemotherapy (for stage III to IV disease). Maintenance therapy consisted of interferon for 1 year and topical nitrogen mustard for 2 years.. Twenty-eight patients were treated. The overall response rate (complete and partial remissions) was 82%. Although the median duration of remission was 5 months in patients with stage III to IV disease, two patients remain in complete remission at 39 + and 46 + months. In patients with stage I to II disease the median duration of remission has not been reached at a median follow-up of 18 months. Five patients, all with stage III to IV disease, have died. Overall, the regimen was well tolerated with one treatment-related death from neutropenic sepsis.. Combined modality therapy may be effective for the treatment of CTCL with similar response rates to other current therapies.

Topics: Administration, Cutaneous; Adult; Aged; Antineoplastic Agents; Antineoplastic Agents, Alkylating; Cause of Death; Combined Modality Therapy; Disease-Free Survival; Female; Follow-Up Studies; Humans; Interferon Type I; Isotretinoin; Keratolytic Agents; Male; Mechlorethamine; Middle Aged; Mycosis Fungoides; Neoplasm Staging; Radiotherapy Dosage; Radiotherapy, High-Energy; Recombinant Proteins; Remission Induction; Sezary Syndrome; Skin Neoplasms; Survival Rate

Retinoids, including isotretinoin, have demonstrated antiproliferative and antineoplastic activity in laboratory and clinical trials. In a phase II trial, 25 patients with extensive mycosis fungoides were evaluated for response to isotretinoin. There was a 44% (11 patients) objective clinical response rate with three clinical complete responses without concomitant evidence of pathologic clearing of the disease. An additional 24% (six patients) showed a minor degree of clinical improvement. The median time to response was two months (range, 0.5 to eight months) and the median response duration was eight months or longer (range, one to 25 months). Chronic toxic reactions consisted primarily of drying of the skin and mucous membranes and resulted in dose reduction in the majority of patients. It is concluded that isotretinoin produces significant clinical benefit to some patients with mycosis fungoides.

Topics: Adult; Aged; Aged, 80 and over; Drug Eruptions; Drug Evaluation; Female; Humans; Isotretinoin; Male; Middle Aged; Mycosis Fungoides; Sezary Syndrome; Skin Neoplasms; Tretinoin; Triglycerides

Topics: Dermatitis, Exfoliative; Humans; Isotretinoin; Sezary Syndrome; Tretinoin

Twenty patients with mycosis fungoides and four with Sézary's syndrome were treated with 13-cis-retinoic acid as single therapy in an initial dose of 1 to 2 mg per kg body weight in most cases. Complete remission in mycosis fungoides was obtained in six cases (33%) and partial remission in another ten cases (50%). No convincing response was observed in three cases, and progression of limited nodular lesions occurred in one case. In cases responding to treatment the first sign of remission was observed within two to four weeks. Our short-term experience is that the drug is effective in early as well as advanced stages of mycosis fungoides. Patients with Sézary's syndrome, however, did not respond to the same extent.

Topics: Adult; Aged; Female; Humans; Isomerism; Isotretinoin; Male; Middle Aged; Mycosis Fungoides; Sezary Syndrome; Skin Neoplasms; Time Factors; Tretinoin