tretinoin 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) is a potentially life-limiting malignant disease. Treatment strategies in CTCL aim at disease control and remission with the lowest possible side-effects.. Recent reports suggest that the new vitamin A derivative alitretinoin might be a well-tolerated treatment option.. We analysed the files of 11 CTCL patients with mycosis fungoides (n = 10) or Sézary syndrome (n = 1), who were treated with oral alitretinoin alone or in combination with standard treatment based on individual off-label treatment decisions. Patients had been monitored every 4-8 weeks with skin examination and laboratory analyses.. Ten of 11 patients (90.9%) showed a marked improvement of their CTCL skin lesions and no progress of the disease during treatment with alitretinoin, one patient showed no response to the treatment (9.1%). Four of the responding patients (40.0%) had a complete response and 6 (60.0%) had a partial response. Average time to response was 2.5 months. Duration of treatment varied depending on whether patients had reached complete or partial remission. In general, alitretinoin was well tolerated. One of 11 patients developed high non-fasting average serum cholesterol (>300 mg/dL) and 1/11 a mean non-fasting triglyceride value >500 mg/dL. In 3/11 patients, thyroid-stimulating hormone declined without clinical symptoms during treatment, with one of the patients also showing a decreased thyroxin level.. In our group of CTCL patients we noticed a low rate of side-effects and an overall good clinical response to treatment with alitretinoin. Further studies are required to substantiate this early clinical observation.

Topics: Administration, Oral; Adrenal Cortex Hormones; Aged; Aged, 80 and over; Alitretinoin; Antineoplastic Agents; Calcineurin Inhibitors; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Mycosis Fungoides; Off-Label Use; Photopheresis; PUVA Therapy; Retreatment; Retrospective Studies; Sezary Syndrome; Treatment Outcome; Tretinoin

Topics: Aged; Alitretinoin; Antineoplastic Agents; Humans; Keratoderma, Palmoplantar; Male; Mycosis Fungoides; Photopheresis; Sezary Syndrome; Skin Neoplasms; Treatment Outcome; Tretinoin

Topics: Antineoplastic Agents; Apoptosis; Bexarotene; CD4-Positive T-Lymphocytes; Cell Culture Techniques; Drug Resistance, Neoplasm; Humans; Sezary Syndrome; Skin Neoplasms; Tetrahydronaphthalenes; Tretinoin

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