Management of Mycosis Fungoides With Chlormethine Hydrochloride Gel in Combination With Systemic Therapies: A Case Series

Tre-P-20 - Evaluation of haematopoietic stem cell transplantation in patients diagnosed with cutaneous T cell lymphoma at a tertiary care centre

Thymoma-associated multiorgan autoimmunity treated with multimodal therapy including extracorporeal photopheresis

Safety and Efficacy of Extracorporeal Photopheresis for Acute and Chronic Graft-Versus-Host-Disease

Outcomes with Extracorporeal Photopheresis in the Management of Chronic Gvhd: A Multi-Centre Experience

A Retrospective Study of Extracorporeal Photopheresis (ECP) in Treatment of Cutaneous T-Cell Lymphoma (CTCL) Evaluating Global, Skin and Blood Responses

Click to increase image sizeClick to decrease image size Potential conflict of interest:Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal

Patients with metastatic skin disease in malignant melanoma can be difficult to treat effectively, often requiring repeated treatments with different modalities in an attempt to control their disease. Treatment of nonsurgically resectable melanoma deposits is unsatisfactory, as they are often multiple and recurring. Anecdotal evidence from individual use of imiquimod in superficial metastases and intralesional interleukin (IL)-2 in subcutaneous deposits suggests that the combination may be more effective in bulky subcutaneous disease. To investigate the combination of topical imiquimod and, for selected lesions, intralesional IL-2, to treat a small cohort of patients with accessible melanoma metastases resistant to other treatments. Thirteen patients were recruited: all had evidence of multiple cutaneous and/or subcutaneous metastases. Imiquimod was applied to the metastases on a daily basis for 4 weeks, before the introduction of intralesional IL-2. This was injected up to three times a week, into selected lesions, with 0.1 mL injected per lesion at a concentration of 3.6 MIU mL(-1), a total of 1 mL being given at each session. The treated lesions were assessed individually at intervals of 3 months. Thirteen patients were treated, with 10 being eligible for assessment. In total, 182 lesions were treated: 137 purely cutaneous lesions and 41 subcutaneous lesions. Overall, a clinical response was seen in 92 lesions (50.5%) with 74 (40.7%) of these being a complete response (CR) with 91% of the CRs being in the cutaneous lesions. New lesions did appear during the treatment course; however, patients with cutaneous disease experienced a marked slowing of the appearance of new cutaneous lesions. No cutaneous lesions that responded reappeared on cessation of treatment. The combination of imiquimod and IL-2 is effective in controlling this mixed cutaneous and subcutaneous disease, and is well tolerated. Imiquimod alone is often enough to elicit a response in purely cutaneous lesions. The addition of intralesional IL-2 increases the response rates in subcutaneous lesions, and in otherwise refractory cutaneous lesions.

Evidence is lacking for a synergistic or additive effect ofcombination extracorporeal photopheresis with interferon alfa for cutaneousT-cell lymphoma

Evidence is lacking for a synergistic or additive effect of combination extracorporeal photopheresis with interferon alfa for cutaneous T-cell lymphoma

5-Azacytidine as Salvage Treatment in Relapsed Myeloid Tumors after Allogeneic Bone Marrow Transplantation

Tre-P-21 - Extracorporeal photopheresis during the COVID-19 pandemic: experience in Argentina

Reduced Intensity Conditioning (RIC) and Hematopoietic Stem Cell Transpalntation (HSCT) Utilizing Extracorporeal Photopheresis (ECP), Fludarabine, and Targeted Dose Busulfan in Children.

Introduction: Mogamulizumab (moga) is an anti-CCR4, monoclonal antibody approved as monotherapy for the treatment of relapsed/refractory mycosis fungoides (MF) and Sezary syndrome (SS). Combination therapies are frequently utilized in cutaneous T-cell lymphoma (CTCL), in part due to the variation in response across blood, nodal, and skin compartments. Little is known about moga in combination with other therapies. Methods: We conducted a single institution retrospective analysis of MF/SS patients who were treated with moga in combination with other systemic therapies, including peginterferon alpha-2a (IFNα), bexarotene, extracorporeal photopheresis (ECP), and oral methotrexate between March 2019 and March 2023. Baseline characteristics and clinical outcomes were recorded and summarized. Responses were assessed by Olsen staging criteria (Olsen et al., 2022). Results: We identified 9 patients treated with moga combination therapy at our institution (Table 1). Six of 7 patients transitioned from mono to combination therapy due to progressive disease or stable disease with uncontrolled symptom burden. Median time to next treatment was 157.5 days (range 42-330) for moga monotherapy. The best response observed in the 8 patients to single agent moga was classified as: 4 (50%) partial responses (PR), 3 (37.5%) stable disease (SD), and 1 (12.5%) progressive disease (PD). We identified a total of 7 different treatment combinations in our 9 patients (6 systemic therapies and 2 skin-directed), which included IFNα (n = 4), bexarotene (2), ECP (2), total skin electron beam radiation (TSEB) (2), narrow band ultraviolet-B therapy (NBUVB) (1), IFNα + ECP (2), and oral methotrexate (1). Multiple patients received more than one combination treatment. Among the combination therapies, the median time to next treatment was 137 days (range 24-224 days) with 2 out of 6 patients having ongoing responses to moga + IFNα +/- ECP. The patient with PR on moga + IFNα received 7 prior therapies. His skin involvement improved from T4 to T1 but significant disease in the blood persisted (B2). He continues moga + IFNα now 846 days later. Conclusions: Mogamulizumab has improved outcomes for MF/SS patients, but global complete responses are rare with the best responses seen in blood. In our series, the addition of IFNα provided clinical benefits to patients with SD or PD on single agent moga. One patient achieved a lengthy partial response despite persistent disease seen in peripheral blood samples. We speculate the combination of moga + IFNα may augment antibody-dependent cellular cytotoxicity thereby improving efficacy of moga. Additionally, combinatorial approaches may improve responses in skin, nodes, and viscera where lower responses are observed to single agent moga. Further investigations of moga combinations are needed. Keywords: Combination Therapies, Cutaneous non-Hodgkin lymphoma No conflicts of interests pertinent to the abstract.

Donor Leukocyte Infusions (DLIs) for Recurrent Hodgkin Lymphoma (HL) Following Allogeneic Stem Cell Transplantation (allo-SCT): Ten-Year Experience at the M.D. Anderson Cancer Center

Extracorporeal Photopheresis As Second Line Therapy for Steroid Refractory Acute Gvhd: Retrospective Study of Long-Term Outcomes