Real-life experience with chlormethine gel for early-stage mycosis fungoides with emphasis on types and management of cutaneous side-effects
Chlormethine gel
adverse effects
cutaneous T-cell lymphoma
early stage
mycosis fungoides
side effects
Journal
The Journal of dermatological treatment
ISSN: 1471-1753
Titre abrégé: J Dermatolog Treat
Pays: England
ID NLM: 8918133
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
pubmed:
25
8
2021
medline:
12
7
2022
entrez:
24
8
2021
Statut:
ppublish
Résumé
Real-life efficacy data on the recently approved once daily application of chlormethine gel (CG) for mycosis fungoides (MF) is limited, and detailed characterization of the side effects and their management are strikingly sparse. To evaluate the efficacy and particularly the side effect profile of CG in early-stage MF patients in a real-life setting. We performed a single-center retrospective analysis of 66 early-stage MF adult patients treated with CG in 2016-2019. Treatment with a once-daily application (52%), or at lower frequencies (48%), in some with topical corticosteroids (TCS) (40%), resulted in an overall response rate of 50%, with no significant difference between stage IA and IB. Cutaneous side effects (56%) included irritant or allergic contact dermatitis (36%, mostly mild/moderate and manageable by reducing application frequency and/or adding TCS or interrupting treatment), unmasking effect (9%), hyperpigmentation (14%), and pruritus (9%). Withdrawal due to side effects occurred in 19.6% of patients (15% for contact dermatitis). In real-life management, flexible regimens of CG sometimes with TCS, show efficacy in early-stage MF and may reduce the rate of contact dermatitis, the main treatment-limiting side effect. Practical recommendations with emphasis of the types, time of appearance, and management of side effects are provided.
Sections du résumé
BACKGROUND
UNASSIGNED
Real-life efficacy data on the recently approved once daily application of chlormethine gel (CG) for mycosis fungoides (MF) is limited, and detailed characterization of the side effects and their management are strikingly sparse.
OBJECTIVE
UNASSIGNED
To evaluate the efficacy and particularly the side effect profile of CG in early-stage MF patients in a real-life setting.
METHODS
UNASSIGNED
We performed a single-center retrospective analysis of 66 early-stage MF adult patients treated with CG in 2016-2019.
RESULTS
UNASSIGNED
Treatment with a once-daily application (52%), or at lower frequencies (48%), in some with topical corticosteroids (TCS) (40%), resulted in an overall response rate of 50%, with no significant difference between stage IA and IB. Cutaneous side effects (56%) included irritant or allergic contact dermatitis (36%, mostly mild/moderate and manageable by reducing application frequency and/or adding TCS or interrupting treatment), unmasking effect (9%), hyperpigmentation (14%), and pruritus (9%). Withdrawal due to side effects occurred in 19.6% of patients (15% for contact dermatitis).
CONCLUSION
UNASSIGNED
In real-life management, flexible regimens of CG sometimes with TCS, show efficacy in early-stage MF and may reduce the rate of contact dermatitis, the main treatment-limiting side effect. Practical recommendations with emphasis of the types, time of appearance, and management of side effects are provided.
Identifiants
pubmed: 34427536
doi: 10.1080/09546634.2021.1967266
doi:
Substances chimiques
Dermatologic Agents
0
Mechlorethamine
50D9XSG0VR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM