Staging and treatment with cyclophosphamide, vincristine and prednisone (CVP) in advanced cutaneous T-cell lymphomas

Twenty-three consecutive patients with cutaneous T-cell lymphomas were submitted to staging procedures including lymphangiography, bone marrow biopsy and aspiration, peripheral blood morphological examination, peritoneoscopy with liver and spleen biopsy, and in selected patients lymph node biopsies. Extracutaneous disease (lymph nodes, bone marrow, liver and spleen) was detected in 12 patients. Bone marrow was involved in 25 per cent of the patients at presentation (all patients had lymph node involvement) and in two of nine patients with advanced disease during the follow-up. Peripheral blood was involved in 65 per cent of the patients at presentation (ten patients with advanced disease) and in six of nine patients with advanced disease during the follow-up. In 16 patients with advanced disease (T3-T4 and/or extracutaneous disease), CVP was given with a 50 per cent objective response rate and four complete remissions of 47+, 12+, 19 and 19 months duration. Median survival of patients with advanced disease was 4 years.