Document Detail


Extracorporeal photopheresis and adjuvant aerosolized granulocyte-macrophage colony-stimulating factor for Sézary syndrome.
MedLine Citation:
PMID:  11838656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Encouraged by preliminary phase 1 studies of aerosolized granulocyte-macrophage colony-stimulating factor (GM-CSF, sargramostim) in the treatment of patients with melanoma and other malignancies, we treated a 72-year-old patient with Sézary syndrome, using alternate-week cycles of aerosolized GM-CSF in combination with monthly cycles of extracorporeal photopheresis (ECP). Sézary syndrome, one of the more aggressive forms of cutaneous T-cell lymphoma, is a devastating and highly symptomatic form of non-Hodgkin lymphoma in which malignant clones of mature helper CD4 T cells, containing large, convoluted nuclei known as Sézary cells, circulate in the blood and infiltrate skin. Extracorporeal photopheresis, an immunomodulatory therapy, has become a primary treatment for patients with Sézary syndrome. This pheresis-based therapy combines psoralen and ultraviolet A radiation as systemic photochemotherapy to induce immune responses. However, the activity and efficacy of ECP vary considerably. To our knowledge this is the first patient with Sézary syndrome treated with adjuvant aerosolized GM-CSF combined with ECP. It produced clinical improvement and decreased the number of circulating Sézary cells in a previously ECP-refractory patient.
Authors:
Saskia A Bouwhuis; Svetomir N Markovic; Marian T McEvoy; Mark R Pittelkow
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings. Mayo Clinic     Volume:  77     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-12     Completed Date:  2002-02-27     Revised Date:  2007-10-29    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-200     Citation Subset:  AIM; IM    
Affiliation:
Department of Dermatology, Mayo Clinic, Rochester, Minn 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Aerosols
Aged
Biopsy
Blood Cell Count
CD4-Positive T-Lymphocytes
Combined Modality Therapy
Granulocyte Macrophage Colony-Stimulating Factors, Recombinant / immunology,  pharmacology,  therapeutic use*
Humans
Middle Aged
Photopheresis / methods*
Prognosis
Sezary Syndrome / blood,  diagnosis,  etiology,  immunology,  therapy*
Skin Neoplasms / blood,  diagnosis,  etiology,  immunology,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Aerosols; 0/Granulocyte Macrophage Colony-Stimulating Factors, Recombinant; 123774-72-1/sargramostim

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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