{Reference Type}: Journal Article
{Title}: On the Way to Curing Advanced-Stage Mycosis Fungoides/Sézary Syndrome.
{Author}: Purnak S;Hosing C;Dabaja B;Bassett RL;Huen A;Duvic M;
{Journal}: Clin Lymphoma Myeloma Leuk
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 14
{Factor}: 2.822
{DOI}: 10.1016/j.clml.2024.07.011
{Abstract}: <B>BACKGROUND: </B>Advanced-stage mycosis fungoides (MF) and Sézary syndrome (SS) have poor prognosis with median survivals of less than 5 years. Although a variety of treatments are approved for MF/SS patients, durable complete remissions (CR) are rare.<BR><B>METHODS: </B>Advanced-stage MF or SS patients who achieved CR and maintained in CR or stage IA for more than 10 years were identified by a retrospective search of the principal investigator's database.<BR><B>RESULTS: </B>Of 2266 patients diagnosed with MF or SS, 23 patients with advanced-stage MF/SS (6 IIB, 1 IIIB, 5 IVA1, 3 IVA2, 8 IVB) who achieved CR and maintained in CR or stage IA for ≥ 10 years were identified. As final/curative treatment, 11 patients underwent allogeneic stem cell transplantation (SCT). Most patients presented at young age, underwent SCT with reduced intensity conditioning regimen, had matched related donors, and controllable post-transplant graft versus host disease. Eleven patients were treated with TSEB as part of combined modality protocol in 2 patients and debulking therapy before allogeneic SCT in 9 patients. Five stage IIB patients achieved CR with radiotherapy. Four patients with blood involvement were treated with extracorporeal photopheresis (ECP) in combination with long-term antibiotics and immunomodulatory agents. Long-term antibiotics were given to 14 patients.<BR><B>CONCLUSIONS: </B>TSEB followed by allogeneic SCT, radiotherapy, ECP plus long-term antibiotics and immunomodulatory agents were the most common curative/final treatments found in our patients. We are reporting the details of our long-term complete responders' treatment course in the hopes of obtaining more cure responses in the future.