The report by Fraser-Andrews et al1 of their experience with extracorporeal photopheresis (ECP) treatment of patients with leukemic cutaneous T-cell lymphoma (CTCL) who had previously failed treatment with systemic chemotherapy provides valuable information. Since most of the previously reported patients received ECP as an initial systemic therapy, the study patients of Fraser-Andrews et al differ in this quite important way from those whom we and other investigators have treated with this type of active immunotherapy. The median survival of 39 months for the patients in the study of Fraser-Andrews et al did not differ in a statistically significant manner from the median survival of 22 months for their historical control group, and was shorter than the 60 to 100 months in prior reports in which many of the best responders also had clear evidence of clonal malignant cells. The relatively poorer survival data of Fraser-Andrews and colleagues may result from their ECP recipients having been selected from those for whom systemic chemotherapy had not been adequate management.
Edelson RL. Sézary Syndrome, Cutaneous T-Cell Lymphoma, and Extracorporeal Photopheresis. Arch Dermatol. 1999;135(5):600–601. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-5-dlt0599
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