Extracorporeal Photopheresis in the Treatment of Mycosis Fungoides and Sézary Syndrome

Dermatol Clin. 2015 Oct;33(4):765-76. doi: 10.1016/j.det.2015.05.011. Epub 2015 Jul 29.

Abstract

Extracorporeal photopheresis (ECP) is an immunomodulating procedure that leads to an expansion of peripheral blood dendritic cell populations and an enhanced TH1 immune response in cutaneous T-cell lymphoma (CTCL). Because of its excellent side effect profile and moderate efficacy, ECP is considered first-line therapy for erythrodermic mycosis fungoides (MF) and Sézary syndrome. Patients with a measurable but low blood tumor burden are most likely to respond to ECP, and the addition of adjunctive immunostimulatory agents may also increase response rates. There may be a role for ECP in the treatment of refractory early stage MF, but data are limited.

Keywords: Cutaneous T-cell lymphoma; Extracorporeal photopheresis; Mycosis fungoides; Photochemotherapy; Sézary syndrome.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Chemotherapy, Adjuvant / methods
  • Humans
  • Immunomodulation
  • Methoxsalen / pharmacokinetics
  • Methoxsalen / therapeutic use
  • Mycosis Fungoides / drug therapy*
  • Mycosis Fungoides / mortality
  • Photopheresis / adverse effects
  • Photopheresis / methods*
  • Photosensitizing Agents / pharmacokinetics
  • Photosensitizing Agents / therapeutic use
  • Sezary Syndrome / drug therapy*
  • Sezary Syndrome / mortality
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / mortality
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Photosensitizing Agents
  • Methoxsalen