Low-dose gemcitabine efficacious in three patients with tumor-stage mycosis fungoides

Mycosis fungoides is the most common subtype of mature T-cell lymphoma that primarily arises in the skin. The tumor manifests as patches, plaques, tumors, or erythroderma and can secondarily involve lymph nodes, peripheral blood, and visceral organs. In advanced tumor stage, chemotherapy is a second-line approach, which is generally not considered curative. Initially, most patients profit from this treatment, but observed remissions usually do not exceed several months. Because of possible immunosuppressive effects in vulnerable patients, the overall benefit of chemotherapy itself is not unequivocal in cutaneous T-cell lymphoma. We report 3 patients whose tumor-stage mycosis fungoides was not sufficiently controlled by several preceding systemic therapies, including liposome-encapsulated doxorubicin. All patients experienced excellent improvement with 250 mg/m2 gemcitabine weekly, a low-dose regimen that is predicted to be less toxic compared with standard-dose gemcitabine.