Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Photodermatol Photoimmunol Photomed. 2012 Oct;28(5):250-7. doi: 10.1111/j.1600-0781.2012.00689.x.
Extracorporeal photopheresis (ECP) is effective for treating cutaneous T-cell lymphoma. In 1987, a pivotal trial showed 81% overall response rate (ORR) using outdated criteria. No long-term follow-up was available for assessing survival. This study applies modern criteria to the 1987 trial to assess the impact of ECP on skin responses and also updates overall survival of the cohort.
Generalized erythroderma (GE, stage T4, n = 31) or extensive patch-plaque (EPP, stage T2, n = 8) patients received ECP (mean 3.9 years' duration). Patients achieving ≥ 50% partial skin response, ≥ 90% near-complete skin response, treatments required, and duration of response (DOR) were determined. Overall survival (OS) from diagnosis and first ECP treatment was determined for all patients and the GE cohort.
Patients showed 74% skin ORR using modern criteria; 33% of patients achieved ≥ 50% partial skin response (after median 7.1 months, mean 23 ECP treatments); 41% achieved ≥ 90% improvement (after median 19.6 months, mean 40 ECP treatments). Mean DOR was 14 months for ≥ 50% improvement and 8.9 months for ≥ 90% improvement. Response rates were comparable for GE and EPP cohorts. Median OS was 9.2 years from diagnosis and 6.6 years from ECP initiation (71.6 months follow-up).
Analysis of long-term follow-up confirmed durable responses and prolonged survival of patients treated with ECP.
体外光分离疗法（ECP）对治疗皮肤 T 细胞淋巴瘤有效。1987 年，一项关键性试验使用过时的标准显示出 81%的总体缓解率（ORR）。没有长期随访来评估生存情况。本研究应用现代标准来评估 1987 年试验中 ECP 对皮肤反应的影响，并更新队列的总生存情况。
接受 ECP 治疗的患者患有全身性红皮病（GE，T4 期，n=31）或广泛斑块型（EPP，T2 期，n=8）。评估达到≥50%部分皮肤缓解、≥90%接近完全皮肤缓解、所需治疗次数和缓解持续时间（DOR）的患者。所有患者和 GE 队列的总生存（OS）从诊断和首次 ECP 治疗开始进行评估。
患者使用现代标准显示出 74%的皮肤 ORR；33%的患者达到≥50%的部分皮肤缓解（中位数为 7.1 个月，平均 23 次 ECP 治疗）；41%的患者达到≥90%的改善（中位数为 19.6 个月，平均 40 次 ECP 治疗）。≥50%改善的平均 DOR 为 14 个月，≥90%改善的平均 DOR 为 8.9 个月。GE 和 EPP 队列的缓解率相当。诊断后中位 OS 为 9.2 年，ECP 开始后中位 OS 为 6.6 年（71.6 个月随访）。
长期随访的分析证实了接受 ECP 治疗的患者的持久反应和延长的生存。
