Combined modality therapy for cutaneous T-cell lymphoma

J Am Acad Dermatol. 1996 Jun;34(6):1022-9. doi: 10.1016/s0190-9622(96)90282-0.


Background: 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.

Objective: Our purpose was to combine known effective agents sequentially to determine whether we could achieve remission in more patients or for longer duration.

Methods: 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.

Results: 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.

Conclusion: Combined modality therapy may be effective for the treatment of CTCL with similar response rates to other current therapies.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Cause of Death
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Interferon Type I / administration & dosage
  • Interferon Type I / adverse effects
  • Interferon Type I / therapeutic use
  • Isotretinoin / administration & dosage
  • Isotretinoin / adverse effects
  • Isotretinoin / therapeutic use
  • Keratolytic Agents / administration & dosage
  • Keratolytic Agents / adverse effects
  • Keratolytic Agents / therapeutic use
  • Male
  • Mechlorethamine / administration & dosage
  • Mechlorethamine / adverse effects
  • Mechlorethamine / therapeutic use
  • Middle Aged
  • Mycosis Fungoides / therapy*
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Radiotherapy, High-Energy / adverse effects
  • Recombinant Proteins
  • Remission Induction
  • Sezary Syndrome / therapy*
  • Skin Neoplasms / therapy*
  • Survival Rate


  • Antineoplastic Agents
  • Antineoplastic Agents, Alkylating
  • Interferon Type I
  • Keratolytic Agents
  • Recombinant Proteins
  • Mechlorethamine
  • Isotretinoin