"Incurable" Skin Cancers May Be Amenable to Radiation Plus Stem Cell Transplant
Last Updated: 2010-04-05 17:48:04 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Skin irradiation followed by stem cell transplantation holds promise for patients with advanced mycosis fungoides or Sezary syndrome, new research shows.
These two diseases are the most common cutaneous T-cell lymphomas. Survival rates with advanced mycosis fungoides, or Sezary syndrome at any stage, are very poor. Sezary syndrome has an 11% 5-year survival rate, according to the researchers.
But in their March 29th online paper in the Journal of Clinical Oncology, the investigators - all from The University of Texas M. D. Anderson Cancer Center, Houston -- report better outcomes in a study of 19 patients with these two conditions.
"Total skin electron beam radiation followed by an allogeneic stem cell transplant is capable of inducing long term complete remissions in Sezary patients who are otherwise resistant to therapy," lead author Dr. Madeleine Duvic told Reuters Health by email.
The patients were treated between 2001 and 2008. Follow-up in late 2009 showed that 6 (31%) patients had died, including 4 who were in complete remission.
The 2-year survival rate is 79%, and progression-free survival is 53%. Two-year "non-relapse mortality-free survival" is 88%, according to the paper.
Of 13 living patients, 11 (85%) are in complete remission, and 2 have stable skin disease. At a median-follow-up of 1.7 years, the median overall survival has not been reached.
"Historically, the prognosis for patients with transformed mycosis fungoides or Sezary syndrome is less than 2.5 years," the researchers note.
Thus, they conclude, their approach is promising and effective and "merits additional study in high-risk patients with advanced disease who had poor survival and matched donors."
J Clin Oncol 2010.
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