Treatment of Drug-Resistant Mycosis Fungoides and Sezary Syndrome

Abstract

Background. The most common diseases among cutaneous T-cell lymphomas are mycosis fungoides (MF) and its leukemic variant Sezary Syndrome (SS). These malignant tumors have a progressive character course. To date, no therapy for these diseases has proven effective, especially in the late stages of the disease. Aim. We aimed to assess the effectiveness of treating resistant forms of MF/SS with prolonged gemcitabine regimen after initial treatment failure. Materials & Methods. The study included 14 patients with drug-resistant forms of MF/SS (10 patients with MF, 3 patients with SS, and 1 patient with the transformation of MF into large cell lymphoma). The median age was 62 years (range 34-78 years). The study population included 9 males and 7 females. Gemcitabine was administered at a dosage of 250 mg/m² as a 6-8 hour IV infusion weekly, in a cycle of 21-28 days. Results. The overall response was 79 % (29 % of patients with complete remission, 50 % of patients with partial remission). In 21 % of patients, the treatment results met the criteria for tumor stabilization. The disease progression was observed in 2 (14 %) patients. This study demonstrates the potential of using prolonged gemcitabine regimen in patients of different age groups with advanced resistant MF/SS who received at least two courses of previous ineffective therapy. In order to evaluate long-term results, further research is needed. Conclusion. The administration of prolonged gemcitabine regimen may be a treatment of choice in resistant forms of MF/SS after initial treatment failure in different age groups including elderly patients.