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Low-dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients
Herschel S Zackheim1, Mohammed Kashani-Sabet, Alex McMillan
1Department of Dermatology, Cancer Center, University of California-San Francisco, USA. hszackheim@orca.ucsf.edu
Background:
Although low-dose methotrexate has been used to treat mycosis fungoides for many years, documentation is very limited.
Objective:
Our purpose was to review our experience with methotrexate in the treatment of 69 patients with patch/plaque and tumor stage mycosis fungoides observed for up to 201 months.
Methods:
This was a retrospective study. Data are presented in terms of response rates and time to treatment failure.
Results:
The greatest number of patients (60) had patch/plaque stage T2 disease (>/=10% skin involved). Of these, 7 (12%) achieved complete remission and 13 (22%) achieved partial remission for a total response rate of 20 of 60 (33%). The median time to treatment failure was 15 months. Only 1 of 7 patients with tumor stage disease responded. Side effects caused treatment failure in 6 (9%) of the total cohort of 69 patients.
Conclusion:
Low-dose methotrexate may be of value in the treatment of a subset of patients with patch/plaque mycosis fungoides resistant to other therapies.
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