PDF(Pubmed)
Abstract：
Topical chlormethine gel has been approved as monotherapy for treatment of adult patients with mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma. In clinical practice, chlormethine gel is often combined with other skin-directed or systemic therapies to optimize response and target recalcitrant lesions. Positive outcomes with combination regimens using chlormethine gel and topical corticosteroids, phototherapy, retinoids, methotrexate, or interferon-α have been reported in literature. However, there are no treatment guidelines on the use of combination regimens with chlormethine gel. To provide real-world evidence and guidance on the use of chlormethine gel combination regimens, several cases of patients treated with chlormethine gel combined with phototherapy (n = 5), retinoids (n = 16), or mogamulizumab (n = 3) are presented. These different combination regimens showed promising results. Most patients had a complete or partial response following treatment and the combinations were well-tolerated over extended treatment periods. Patients receiving chlormethine gel with retinoids had long-term periods of remission, even after treatment discontinuation. Durations of response of up to 3 years were observed in these patients. This long-term disease control may be the result of disease-modifying effects of chlormethine. Previous studies have shown targeted reductions in malignant T-cell clones in patients treated with chlormethine gel as well as improved post-treatment responses. Further research is needed to determine the effectiveness and safety of combination treatment regimens with chlormethine gel and to assess the impact chlormethine gel has on disease control.
摘要：
外用氯甲宾凝胶已被批准作为治疗成人支原体（MF）患者的单一疗法，皮肤T细胞淋巴瘤最常见的形式。在临床实践中,氯甲芬凝胶通常与其他皮肤定向或全身治疗相结合，以优化反应并靶向顽固性病变。使用氯甲宁凝胶和局部皮质类固醇的联合方案的积极结果，光疗,类维生素A，甲氨蝶呤,或干扰素-α已在文献中报道。然而,没有关于使用氯甲芬凝胶联合治疗方案的治疗指南.为使用氯甲芬凝胶联合方案提供真实世界的证据和指导，几例氯甲芬凝胶联合光疗治疗的患者（n=5），类维生素A（n=16），或mogamulizumab（n=3）。这些不同的组合方案显示了有希望的结果。大多数患者在治疗后有完全或部分反应，并且这些组合在延长的治疗期内耐受性良好。接受含有维甲酸类的氯甲芬凝胶的患者有长期的缓解期，即使在治疗停止后。在这些患者中观察到长达3年的反应持续时间。这种长期的疾病控制可能是氯甲基的疾病改善作用的结果。先前的研究表明，用氯甲芬凝胶治疗的患者中恶性T细胞克隆的靶向减少以及改善的治疗后反应。需要进一步的研究来确定氯甲芬凝胶联合治疗方案的有效性和安全性，并评估氯甲芬凝胶对疾病控制的影响。
