Photopheresis as an Interventional Therapy for the Treatment of CTCL (Cutaneous T-Cell Lymphoma, Mycosis Fungoides) Stage 1A, 1B, 2A
Cutaneous T Cell Lymphoma, Mycosis Fungoides
About this trial
This is an interventional treatment trial for Cutaneous T Cell Lymphoma focused on measuring ECP, Photopheresis, CTCL, Cutaneous T Cell Lymphoma, Mycosis Fungoides
Eligibility Criteria
Inclusion Criteria: Patients are to be greater than 40 kg body weight. Patients must have adequate veins to provide intravenous access. Women who are not pregnant, lactating, or of childbearing potential. Lack of childbearing potential was defined as: Being post-menopausal Being surgically sterile Practicing contraception Patients with childbearing potential had to have a negative serum human chorionic gonadotropin (HCG) upon entrance into the study. Patients must be willing to adhere to the protocol, and sign an Informed Patient Consent Form prior to entry into the study. Patients must not be on any other investigational device/drug treatment. Patients with the diagnosis of mycosis fungoides (MF) including a skin biopsy consistent with MF (atypical epidermotrophic or folliculocentric T-cells). Appropriate staging as IA, IB or IIA : T1 or T2 (patches or plaques) with measurable lesions. IA patients must show evidence of a minor blood abnormality by morphology or laboratory assessment. For IIA patients - clinically significant nodes (1.5 cm) must have lymph node biopsy showing dermatopathic nodes or no involvement. Patients must be willing and able to discontinue concomitant medications for MF. Patients currently taking the following drugs must discontinue medication prior to enrollment in the trial: Psoralens and ultraviolet A (PUVA) or ultraviolet B (UVB) therapy - 4 weeks Topical nitrogen mustard or other topical chemotherapy - 4 weeks Bexarotene capsules or other systemic biologic agent - 3 weeks washout High dose topical steroids, topical retinoids or immunotherapy - 2 week washout with 1% topical hydrocortisone Oral steroids above 10 mg - 30 day washout, unless patient has Addison's disease or adrenal insufficiency Patients must be refractory to at least one of the standard therapies used to treat Stage IA, IB or IIA CTCL such as oral steroids, high-dose topical steroids, mechlorethamine (HN2), bexarotene, PUVA therapy, electron beam radiation, biological response or oral methotrexate. Patients must abstain from therapeutic sunbathing, tanning beds, etc. for the duration of the study. Exclusion Criteria: Patients who have MF (T3 cutaneous tumors or T4 exfoliative erythroderma) Stage IIB - IVB, ie. no pathological node or visceral involvement. Patients who are unable to tolerate extracorporeal volume loss (e.g., severe cardiac disease or severe anemia or weight < 40 kg). Patients with recent (within three months) deterioration of renal function who have a serum creatinine level greater than 3.0 mg/dL. Patients with lipemic plasma > 500 ng/dL or uncontrolled diabetes. Patients with a history of liver damage (2.5 x normal ALT, AST) or porphyria. Patients with positive tests for HIV antibody, hepatitis C virus (HCV) antibody or hepatitis B surface antigen. Patients on oral prednisone therapy or full body or high potency topical steroids. Women who are pregnant or nursing a child. Patients with severe emotional, behavioral or psychiatric problems that, in the opinion of the investigator, would result in poor compliance with the treatment regimen. Patients who exhibit idiosyncratic or hypersensitivity reactions to 8-methoxypsoralen compounds, heparin, or citrate. Patients with previous exposure to photopheresis therapy. Patients who use tanning beds or are receiving phototherapy.
Sites / Locations
- Rush-Presbyterian Hospital
- Boston Medical Center
- University of Minnesota
- University Hospital of Cleveland/Case Western Reserve University
- University of Pittsburgh
- Vanderbilt University Medical Center
- MD Anderson Cancer Center
Arms of the Study
Arm 1
Experimental
DRUG+ECP
UVVADEX +ECP will be administered to patients with CTCL.Duration of Treatment: The study will consist of 2 treatment periods, a 6-month initial period and a 6-month follow-up period where photopheresis therapy may continue.