Skip to main content
Top
Published in: BioDrugs 7/2001

01-07-2001 | Review Article

Therapeutic Advances in Biological Response Modifiers in the Treatment of Cutaneous T-Cell Lymphoma

Authors: Dr Carmela C. Vittorio, Alain H. Rook, Lars E. French, Michael Shapiro, Michael S. Lehrer, Jacqueline M. Junkins-Hopkins

Published in: BioDrugs | Issue 7/2001

Login to get access

Abstract

Cutaneous T-cell lymphoma (CTCL) is most often a skin-infiltrating malignancy of clonal CD4+ T-cells. Therapy is based on staging and the likelihood of progression. Biological response modifiers and chemotherapeutic agents are used to preserve the integrity of the host antitumour response while selectively targeting the malignant cells. The biological response-modifying treatment options currently used to treat CTCL are bexarotene, denileukin diftitox, interferon-α, interferon-γ and interleukin-12, as well as extracorporeal photopheresis and phototherapy. A combination therapy approach maximises response in patients with advanced CTCL. Biological response modifiers in combination with photopheresis are used for patients with the leukaemic phase of the disease. Among the majority of patients with advanced stage disease so treated, immune response augmentation appears to prolong survival. Future areas of research should assess not only survival and optimal treatment combinations, but also quality of life during the treatment period.
Literature
1.
go back to reference Diamandidou E, Cohen PR, Kurzrock R. Mycosis fungoides and Sézary syndrome. Blood 1996; 88: 2385–409PubMed Diamandidou E, Cohen PR, Kurzrock R. Mycosis fungoides and Sézary syndrome. Blood 1996; 88: 2385–409PubMed
2.
go back to reference Kim YH, Chow S, Varghese A, et al. Clinical characteristics and long-term outcome of patients with generalized patch or plaque (T2) mycosis fungoides. Arch Dermatol 1999; 135: 26–32CrossRefPubMed Kim YH, Chow S, Varghese A, et al. Clinical characteristics and long-term outcome of patients with generalized patch or plaque (T2) mycosis fungoides. Arch Dermatol 1999; 135: 26–32CrossRefPubMed
3.
go back to reference Vowels BR, Cassin M, Vonderheid E, et al. Aberrant cytokine production by Sézary syndrome patients: cytokine secretion pattern resembles murine Th2 cells. J Invest Dermatol 1992; 99: 90–4CrossRefPubMed Vowels BR, Cassin M, Vonderheid E, et al. Aberrant cytokine production by Sézary syndrome patients: cytokine secretion pattern resembles murine Th2 cells. J Invest Dermatol 1992; 99: 90–4CrossRefPubMed
4.
go back to reference Kim YH, Jensen RA, Watanabe GL, et al. Clinical stage IA (limited patch and plaque) mycosis fungoides. A long-term outcome analysis. Arch Dermatol 1996; 132: 1309–13CrossRefPubMed Kim YH, Jensen RA, Watanabe GL, et al. Clinical stage IA (limited patch and plaque) mycosis fungoides. A long-term outcome analysis. Arch Dermatol 1996; 132: 1309–13CrossRefPubMed
5.
go back to reference Vonderheid EC, Tan ET, Kantor AF, et al. Long term efficacy, curative potential, and carcinogenicity of topical mechlorethamine chemotherapy in cutaneous T-cell lymphoma. J Am Acad Dermatol 1989; 20: 416–28CrossRefPubMed Vonderheid EC, Tan ET, Kantor AF, et al. Long term efficacy, curative potential, and carcinogenicity of topical mechlorethamine chemotherapy in cutaneous T-cell lymphoma. J Am Acad Dermatol 1989; 20: 416–28CrossRefPubMed
6.
go back to reference Kaye FJ, Bunn Jr PA, Steinberg SM, et al. A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides. N Engl J Med 1989; 321: 1784–90CrossRefPubMed Kaye FJ, Bunn Jr PA, Steinberg SM, et al. A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides. N Engl J Med 1989; 321: 1784–90CrossRefPubMed
7.
go back to reference Rook AH, Lessin SR, Jaworsky C, et al. Immunopathogenesis of cutaneous T-cell lymphoma: abnormal cytokine production by Sézary T-cells. Arch Dermatol 1993; 129: 486–9CrossRefPubMed Rook AH, Lessin SR, Jaworsky C, et al. Immunopathogenesis of cutaneous T-cell lymphoma: abnormal cytokine production by Sézary T-cells. Arch Dermatol 1993; 129: 486–9CrossRefPubMed
8.
go back to reference Rook AH, Kubin M, Cassin M, et al. Interleukin 12 reverses cytokine and immune abnormalities in Sézary syndrome. J Immunol 1995; 154: 1491–8PubMed Rook AH, Kubin M, Cassin M, et al. Interleukin 12 reverses cytokine and immune abnormalities in Sézary syndrome. J Immunol 1995; 154: 1491–8PubMed
9.
go back to reference Peleman R, Wu J, Rargeas C, et al. Recombinant interleukin 4 suppresses the production of interferon gamma by human mononuclear cells. J Exp Med 1989; 170; 1751–6CrossRefPubMed Peleman R, Wu J, Rargeas C, et al. Recombinant interleukin 4 suppresses the production of interferon gamma by human mononuclear cells. J Exp Med 1989; 170; 1751–6CrossRefPubMed
10.
go back to reference D’Andrea A, Aste-Amea M, Valiante NM, et al. Interleukin-10 inhibits human lymphocyte IFN-γ production by suppressing natural killer stimulatory factor/interleukin-12 synthesis in accessory cells. J Exp Med 1993; 178: 1041–8CrossRefPubMed D’Andrea A, Aste-Amea M, Valiante NM, et al. Interleukin-10 inhibits human lymphocyte IFN-γ production by suppressing natural killer stimulatory factor/interleukin-12 synthesis in accessory cells. J Exp Med 1993; 178: 1041–8CrossRefPubMed
11.
go back to reference Boehm MF, Heyman RA, Nagpal S. A new generation of retinoid drugs for the treatment of dermatological disease. Emerg Drugs 1997; 2: 287–303CrossRef Boehm MF, Heyman RA, Nagpal S. A new generation of retinoid drugs for the treatment of dermatological disease. Emerg Drugs 1997; 2: 287–303CrossRef
13.
go back to reference Sherman S, Gopal J, Haugen BR, et al. Central hypothyroidism associated with retinoid X receptor-selective ligands. N Engl J Med 1999; 340: 1075–9CrossRefPubMed Sherman S, Gopal J, Haugen BR, et al. Central hypothyroidism associated with retinoid X receptor-selective ligands. N Engl J Med 1999; 340: 1075–9CrossRefPubMed
14.
go back to reference Package insert, Targretin Gel, 1%. Ligand Pharmaceuticals Package insert, Targretin Gel, 1%. Ligand Pharmaceuticals
15.
go back to reference Nichols J, Foss F, Kuzel TM, et al. Interleukin-2 fusion protein: an investigational therapy for interleukin-2 receptor expressing malignancies. Eur J Cancer 1997; 33: S34–6CrossRefPubMed Nichols J, Foss F, Kuzel TM, et al. Interleukin-2 fusion protein: an investigational therapy for interleukin-2 receptor expressing malignancies. Eur J Cancer 1997; 33: S34–6CrossRefPubMed
16.
go back to reference Duvic M, Cather JC, Maize J, et al. DAB389IL-2 diphtheria fusion toxin reduces clinical responses in tumor stage cutaneous T-cell lymphoma. Am J Hematol 1998; 58: 78–90CrossRef Duvic M, Cather JC, Maize J, et al. DAB389IL-2 diphtheria fusion toxin reduces clinical responses in tumor stage cutaneous T-cell lymphoma. Am J Hematol 1998; 58: 78–90CrossRef
17.
go back to reference Olsen EA, Bunn PA. Interferon in the treatment of cutaneous T-cell lymphoma. Hematol Clin North Am 1995; 9: 1089–107 Olsen EA, Bunn PA. Interferon in the treatment of cutaneous T-cell lymphoma. Hematol Clin North Am 1995; 9: 1089–107
18.
go back to reference Olsen EA, Rosen ST, Vollmer RT, et al. Interferon alpha 2a in the treatment of cutaneous T-cell lymphoma. J Am Acad Dermatol 1989; 20: 395–407CrossRefPubMed Olsen EA, Rosen ST, Vollmer RT, et al. Interferon alpha 2a in the treatment of cutaneous T-cell lymphoma. J Am Acad Dermatol 1989; 20: 395–407CrossRefPubMed
19.
go back to reference Rook AH, Yoo EK, Grossman DJ, et al. Use of biological response modifiers in the treatment of cutaneous T-cell lymphoma. Curr Opin Oncol 1998; 10: 170–4CrossRefPubMed Rook AH, Yoo EK, Grossman DJ, et al. Use of biological response modifiers in the treatment of cutaneous T-cell lymphoma. Curr Opin Oncol 1998; 10: 170–4CrossRefPubMed
20.
go back to reference Knobler RM, Radaszkiewicz T. Treatment of cutaneous T-cell lymphoma with a combination of low-dose interferon alfa 2b and retinoids. J Am Acad Dermatol 1991; 24: 247–52CrossRefPubMed Knobler RM, Radaszkiewicz T. Treatment of cutaneous T-cell lymphoma with a combination of low-dose interferon alfa 2b and retinoids. J Am Acad Dermatol 1991; 24: 247–52CrossRefPubMed
21.
go back to reference Dreno B, Celorier P, Litroux P. Roferon-A in combination with Tegason in cutaneous T-cell lymphomas. Acta Haematol 1993; 89 Suppl. 1: 28–32CrossRef Dreno B, Celorier P, Litroux P. Roferon-A in combination with Tegason in cutaneous T-cell lymphomas. Acta Haematol 1993; 89 Suppl. 1: 28–32CrossRef
22.
go back to reference Kuzel TM, Gilyon K, Springer E, et al. Interferon alfa-2a combined with phototherapy in the treatment of cutaneous T-cell lymphoma. J Natl Cancer Inst 1990; 82: 203–7CrossRefPubMed Kuzel TM, Gilyon K, Springer E, et al. Interferon alfa-2a combined with phototherapy in the treatment of cutaneous T-cell lymphoma. J Natl Cancer Inst 1990; 82: 203–7CrossRefPubMed
23.
go back to reference Gottlieb SL, Wolfe JT, Fox FE, et al. Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and with recombinant interferon alfa. J Am Acad Dermatol 1996; 35: 946–57CrossRefPubMed Gottlieb SL, Wolfe JT, Fox FE, et al. Treatment of cutaneous T-cell lymphoma with extracorporeal photopheresis monotherapy and with recombinant interferon alfa. J Am Acad Dermatol 1996; 35: 946–57CrossRefPubMed
24.
go back to reference Fox FE, Niu Z, Lessin S, et al. Cytokine regulation of the growth of clonal malignant T-cells from patients with Sézary syndrome [abstract]. J Invest Dermatol 1997; 108: 552CrossRef Fox FE, Niu Z, Lessin S, et al. Cytokine regulation of the growth of clonal malignant T-cells from patients with Sézary syndrome [abstract]. J Invest Dermatol 1997; 108: 552CrossRef
25.
go back to reference Gottlieb SL, Fox FE, Cassin M, et al. Interleukin 5 expression by peripheral blood mononuclear cells in Sézary syndrome correlates with peripheral eosinophilia and is suppressed by interferon alfa [abstract]. J Invest Dermatol 1995; 104: 683 Gottlieb SL, Fox FE, Cassin M, et al. Interleukin 5 expression by peripheral blood mononuclear cells in Sézary syndrome correlates with peripheral eosinophilia and is suppressed by interferon alfa [abstract]. J Invest Dermatol 1995; 104: 683
26.
go back to reference Platsoucas CD, Fox FE, Oleszak E, et al. Regulation of natural killer cytotoxicity by recombinant alpha interferons: augmentation by IFN-alpha 7, an interferon similar to IFN-alpha. J Anticancer Res 1989; 9: 849–58 Platsoucas CD, Fox FE, Oleszak E, et al. Regulation of natural killer cytotoxicity by recombinant alpha interferons: augmentation by IFN-alpha 7, an interferon similar to IFN-alpha. J Anticancer Res 1989; 9: 849–58
27.
go back to reference Kaplan EH, Rosen ST, Norris DB, et al. Phase II study of recombinant human interferony for treatment of cutaneous T-cell lymphoma. J Natl Cancer Inst 1990; 82: 208–12CrossRefPubMed Kaplan EH, Rosen ST, Norris DB, et al. Phase II study of recombinant human interferony for treatment of cutaneous T-cell lymphoma. J Natl Cancer Inst 1990; 82: 208–12CrossRefPubMed
28.
go back to reference Fox FE, Kubin M, Cassin M, et al. Retinoids synergize with interleukin-12 to augment IFN-gamma and interleukin-12 production by human peripheral blood mononuclear cells. J Interferon Cytokine Res 1999; 19: 407–15CrossRefPubMed Fox FE, Kubin M, Cassin M, et al. Retinoids synergize with interleukin-12 to augment IFN-gamma and interleukin-12 production by human peripheral blood mononuclear cells. J Interferon Cytokine Res 1999; 19: 407–15CrossRefPubMed
29.
go back to reference Rook AH, Wood GS, Yoo EK, et al. Interleukin-12 Therapy of cutaneous T-cell lymphoma induces lesion regression and cytotoxic T-cell responses. Blood 1999; 94: 902–8PubMed Rook AH, Wood GS, Yoo EK, et al. Interleukin-12 Therapy of cutaneous T-cell lymphoma induces lesion regression and cytotoxic T-cell responses. Blood 1999; 94: 902–8PubMed
30.
go back to reference Rook AH, Foss F, Wood G, et al. A phase 2 open-label study reveals that recombinant human interleukin-12 (rhIL-12) is efficacious in patients with early stage cutaneous T-cell lymphoma (CTCL) [abstract]. J Invest Dermatol 2000; 114: 880 Rook AH, Foss F, Wood G, et al. A phase 2 open-label study reveals that recombinant human interleukin-12 (rhIL-12) is efficacious in patients with early stage cutaneous T-cell lymphoma (CTCL) [abstract]. J Invest Dermatol 2000; 114: 880
31.
go back to reference Yoo EK, Rook AH, Elenitsas R, et al. Apoptosis induction by ultraviolet A and photochemotherapy in cutaneous T-cell lymphoma: relevance to mechanism of therapeutic action. J Invest Dermatol 1996; 107: 235–42CrossRefPubMed Yoo EK, Rook AH, Elenitsas R, et al. Apoptosis induction by ultraviolet A and photochemotherapy in cutaneous T-cell lymphoma: relevance to mechanism of therapeutic action. J Invest Dermatol 1996; 107: 235–42CrossRefPubMed
32.
go back to reference Rook AH, Suchin KR, Kao DMF, et al. Photopheresis: clinical applications and mechanisms of action. J Invest Dermatol Symp Proc 1999; 4: 85–9CrossRef Rook AH, Suchin KR, Kao DMF, et al. Photopheresis: clinical applications and mechanisms of action. J Invest Dermatol Symp Proc 1999; 4: 85–9CrossRef
33.
go back to reference Wilson LD, Jones GW, Kim D, et al. Experience with total skin electron beam therapy in combination with extracoporeal photopheresis in the management of patients with erythrodemic (T4) mycosis fungoides. J Am Acad Dermatol 2000; 43: 54–60CrossRefPubMed Wilson LD, Jones GW, Kim D, et al. Experience with total skin electron beam therapy in combination with extracoporeal photopheresis in the management of patients with erythrodemic (T4) mycosis fungoides. J Am Acad Dermatol 2000; 43: 54–60CrossRefPubMed
34.
go back to reference Kuzel TM, Roenigk HH, Samuelson E, et al. Effectiveness of interferon alfa-2a combined with phototherapy for mycosis fungoides and the Sézary syndrome. J Clin Oncol 1995; 13: 257–63PubMed Kuzel TM, Roenigk HH, Samuelson E, et al. Effectiveness of interferon alfa-2a combined with phototherapy for mycosis fungoides and the Sézary syndrome. J Clin Oncol 1995; 13: 257–63PubMed
35.
go back to reference Ramsey DL, Meller JA, Zackheim HS. Topical treatment of early cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 1995; 9: 1031–56 Ramsey DL, Meller JA, Zackheim HS. Topical treatment of early cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 1995; 9: 1031–56
36.
go back to reference Clark C, Dawe RS, Evans AT, et al. Narrowband TL-01 phototherapy for patch-stage mycosis fungoides. Arch Dermatol 2000; 136: 748–52CrossRefPubMed Clark C, Dawe RS, Evans AT, et al. Narrowband TL-01 phototherapy for patch-stage mycosis fungoides. Arch Dermatol 2000; 136: 748–52CrossRefPubMed
37.
go back to reference Suchin KR, DeNardo B, Macey W, et al. Treatment of cutaneous T-cell lymphoma with combined immunomodulatory therapy: a 15-year experience at a single institution. Pacific Dermatologic Association; 2000 Sep 13–17; Victoria, BC Suchin KR, DeNardo B, Macey W, et al. Treatment of cutaneous T-cell lymphoma with combined immunomodulatory therapy: a 15-year experience at a single institution. Pacific Dermatologic Association; 2000 Sep 13–17; Victoria, BC
Metadata
Title
Therapeutic Advances in Biological Response Modifiers in the Treatment of Cutaneous T-Cell Lymphoma
Authors
Dr Carmela C. Vittorio
Alain H. Rook
Lars E. French
Michael Shapiro
Michael S. Lehrer
Jacqueline M. Junkins-Hopkins
Publication date
01-07-2001
Publisher
Springer International Publishing
Published in
BioDrugs / Issue 7/2001
Print ISSN: 1173-8804
Electronic ISSN: 1179-190X
DOI
https://doi.org/10.2165/00063030-200115070-00002

Other articles of this Issue 7/2001

BioDrugs 7/2001 Go to the issue