P99 Broadband UVA versus PUVA in the treatment of early stage mycosis fungoides: a comparative study

Abstract

Background Mycosis fungoides (MF) is the most common type of cutaneous-T-cell lymphoma, with no established consensus for its treatment [1]. The standard treatment for early stage MF is PUVA [2]. UVA1 phototherapy was found to induce marked improvement in skin lesions of patients with stages IA and IB MF. Broad band UVA is composed of 80.1% UVA1, with similar mechanisms of action [3]. Aim of work The aim of the present work was to compare the efficacy of PUVA versus broad band UVA as a substitute to UVA1 in the treatment of early stage MF (IA, IB, IIA). Patients and methods; Thirty patients with early stage MF (IA and IB) were included in this prospective, randomized clinical trial. They were randomly divided into two equal groups; group A (15 patients receiving PUVA) and group B (15 patients receiving BBUVA at 20 J/cm2/session). The patients received three sessions/week for 13 weeks i.e. forty sessions. The patients were compared regarding clinical, histopathological, immunohistochemical (By measuring the bcl-2 level) and overall responses. Results Among each of the two groups, there was statistically significant improvement in the clinical, histopathological, immunohistochemical and overall responses. However there was no statistically significant difference between both groups in any of the aspects with comparable overall success rates; (93.3%) in the PUVA group and (80%) in the BBUVA group. Excellent overall response rates was higher in the BB-UVA group (41.7%) versus (14.3%) in the PUVA group, but still with no statistically significant difference (P=0.117). As regards the side effects encountered in both groups; there was no statistically significant difference in the rates of tanning, pruritus, appearance of new lesions, photosensitivity or dryness. However discomfort was significantly higher among the BB-UVA group (P=0.032) and nausea was significantly higher among the PUVA group (P=0.003). Conclusion BB-UVA is a new, yet promising therapeutic modality in the treatment of early stage MF, as it is comparable to PUVA, as regards both the efficacy and safety. It could substitute the use of UVA1 in the treatment of early stage MF.