Cutaneous T-cell lymphoma: clinicopathological relationships, therapy and survival in ninety-two patients

Clinicopathological findings, methods of treatment and survival in ninety-two patients with cutaneous T-cell lymphoma (CTCL) (eighty-five mycosis fungoides and seven Sézary syndrome), seen in the Leiden University Hospital between 1974 and 1980, are reported. All patients were staged and treatment was given accordingly. Patients without signs of extracutaneous disease (74%) were treated with eigher total-skin electron-beam irradiation (E beam), topical mechlorethamine (HN2) or PUVA. Topical HN2 and E beam had an equal effect on survival. Electron-beam induced a higher number of initial complete remissions than HN2, but fewer patients relapsed while on maintenance treatment with HN2. In the patients with lymph node and/or visceral involvement, E beam followed by systemic chemotherapy--cyclophosphamide, vincristin (Oncovin) and prednisone (COP)--gave better results than topical therapy or COP alone. Survival was influenced most by the type of skin lesion, the presence or absence of lymph node and/or visceral involvement, and the ability to induce a complete remission initially.