Treatment of Drug-Resistant Forms of Mycosis Fungoides/Sezary Syndrome

Mycosis Fungoides (MF) and leukemic variant - Sezary Syndrome (SS) are the most frequent diseases among cutaneous T-cell lymphomas. These tumors have a chronic progradient nature. Up to present time there is no evident of effective therapy, particularly late-stage of diseases.

About 30% of patients have no effect from interferon, radiotherapy and combined treatment regimens. Older age (median age - ...) of such patients limits therapy options. Several lines of previous treatment lead to tumor resistance and higher accumulated toxicity. Thus, use of potentially effective chemotherapeutic agents in lower doses will reduce myelotoxicity and increase the cohort of patients. Gemcitabine is an effective medication in treatment of MF/SS. Its efficacy is preserved in small doses with prolonged duration of infusion and allows decreasing myelotoxicity. It was firstly discovered in therapy of solid tumors.

In current study were involved 14 patients with resistant forms of MF/SS (10 patients - GM 3 - SS, 1 case GM transformation into large cell lymphoma). We used 6-hour infusion of gemcitabine at dosage of 250 mg/m². 86% of patients achieved a general response: 29% complete remission, 50% - partial remission, 21% - stabilization of disease, 14% (2 patients)-progression.

Present study showed promising results in treatment of patients with advanced stages of MF/SS which had at least two preceding lines of therapy without an effect. Common response (PR/CR) was received in high percent of cases. This treatment protocol is reproducible in elderly patients. For long-term conclusions further studies are needed.