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Is PUVA maintenance therapy necessary in patients with early‐stage mycosis fungoides? Evaluation of a treatment guideline over a 28‐month follow‐up
Author(s) -
Sánchez María A.,
González Tatiana,
Gaitán Miguel F.,
Zuluaga Ángela,
Jiménez Sol B.,
de Galvis Yolanda T.
Publication year - 2011
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2010.04833.x
Subject(s) - medicine , mycosis fungoides , guideline , stage (stratigraphy) , radiation therapy , population , cutaneous t cell lymphoma , surgery , confidence interval , puva therapy , lymphoma , dermatology , psoriasis , pathology , paleontology , environmental health , biology
Background Cutaneous T‐cell lymphoma is a rare condition that represents 2% of all lymphomas and 75–80% of primary cutaneous lymphomas. The objective of the present study is to evaluate a clinical practice guideline. Methods This paper reports a prospective cohort study with a five‐year follow‐up. This is the second report to describe the analysis of data obtained during follow‐up of 28 months. To date, 40 patients diagnosed with early‐stage mycosis fungoides (stage IA, n = 20; stage IB, n = 20) have been enrolled. All patients have been treated with a minimum of 58 sessions of psoralen and long‐wave ultraviolet radiation, with complete clinical and histological clearance of lesions. Variables considered include disease duration, treatment time, treatment dose, and history of relapse. Complete physical examinations and diverse complementary examinations were performed. A tumor–node–metastasis–blood staging system was applied. The population was divided into two groups according to results consisting, respectively, of those who relapsed during follow‐up ( n = 12) and those who did not ( n = 28). Results History of relapse was the variable most strongly associated with future relapse (relative risk = 10.38, 95% confidence interval 2.64–40.72). No statistically significant difference between the groups according to receipt of maintenance therapy was found ( P = 0.161). Conclusions Our results strongly suggest that maintenance therapy does not prevent future relapse. However, history of relapse is a strong predictor for future relapse.