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August 1996

Successful Treatment of Sézary Syndrome With Lymphomatous Transformation to Large Cell Lymphoma With Fludarabine Phosphate

Arch Dermatol. 1996;132(8):978-979. doi:10.1001/archderm.1996.03890320128028

Sézary syndrome (SS), a leukemic form of cutaneous T-cell lymphoma (CTCL), is highly resistant to contemporary therapeutic modalities. A more aggressive form of disease that is even less responsive to therapy and characterized by transformation to large cell lymphoma develops in a substantial percentage of patients with SS. We describe a patient with SS that underwent lymphomatous transformation to large cell lymphoma. Treatment with the nucleoside analogue fludarabine phosphate resulted in complete remission for 14 months.

Report of a Case.  A 72-year-old white woman sought treatment because of an 11-month history of a chronic, relapsing, intensely pruritic eruption that had progressed to a generalized erythroderma. She had been treated with topical and systemic corticosteroids, oral psoralen with UV-A, etretinate, and hydroxyurea without substantial improvement. A physical examination revealed diffuse erythema and multiple, widespread, thin, scaly plaques. Erythema and keratoderma of her palms and soles were present. Laboratory data revealed

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