Long-term Follow-up of Patients With Early-Stage Cutaneous T-Cell Lymphoma Who Achieved Complete Remission With Psoralen Plus UV-A Monotherapy

摘要: Objectives To evaluate long-term outcomes, impact of maintenance therapy and potential curability patients with mycosis fungoides (MF) treated psoralen plus UV-A (PUVA) monotherapy. Design Single-center retrospective cohort analysis. Setting Academic referral center for cutaneous lymphoma. Patients A total 66 104 clinical stages IA to IIA MF who achieved complete remission (CR) after PUVA monotherapy between 1979 1995. Main Outcome Measures Kaplan-Meier actuarial survival disease-free curves were compared stage IB/IIA cases. stratified into relapse nonrelapse groups based on whether their relapsed during study follow-up. Baseline characteristics treatment these groups. Results Median follow-up time was 94 months (range, 5-242 months). Thirty-three maintained CR 84 5-238 months), 33 experienced a median interval 39 2-127 There no significant difference in baseline the Those group received higher cumulative dosage ( P  = .03) required longer periods achieve  = .03). Disease-free rates at 5 10 years all 56% 30%, respectively, IB/IIA, 74% 50%. Actuarial 5, 10, 15 94%, 82%, IA, 80%, 69%, 58% IB/IIA. The overall rate did not show any statistical difference. One third developed signs chronic photodamage secondary malignancies. Conclusions Psoralen is an effective MF, inducing remissions perhaps some cases disease “cure.” Thirty percent 50% remain free years, but late relapses occur. Long-term affected by status, risk needs be measured against possible benefit greater elimination.