Advanced mycosis fungoides: chemotherapy with etoposide, methotrexate, bleomycin, and prednimustine

We assessed the efficacy and toxicity of a chemotherapeutic regimen in patients with stage II-IV mycosis fungoides. Eleven previously treated outpatients received etoposide and methotrexate p.o. and bleomycin i.v. every 3 weeks. There was 1 complete remission for 2 months and 7 partial remissions with a median duration of 6 months (range 2-16 months). Three patients showed stable disease lasting 1-5 months (median 2 months). In 4 patients, remissions were maintained with prednimustine after 10 courses of induction chemotherapy. Mild nausea occurred in all patients and severe leukocytopenia and thrombocytopenia in 1 patient. Toxicity of the treatment regimen was acceptable and response rates comparable to those seen by others with more toxic single-agent or combination chemotherapies.