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Efficacy and Side Effects of Narrowband-UVB in Early Stage Cutaneous T-Cell Lymphoma in Jordanian Patients

DOI: 10.1155/2014/951821

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Abstract:

Background. Many studies, on light-skinned patients, suggested narrowband-UVB to be effective and safe for the treatment of early stage cutaneous T-cell lymphoma. Objectives. To evaluate the efficacy and side effects of narrowband-UVB in treatment of early stage cutaneous T-cell lymphoma in patients with skin phototypes III, IV, and V. Methods. A total of 27 patients with the diagnosis of early stage cutaneous T-cell lymphoma were involved in this prospective study. All patients received narrowband-UVB as monotherapy until clearance or a maximum of 42 sessions. Patients with complete clearance were followed for six months or relapse. Rate of clearance, number of sessions, and cumulative narrowband-UVB dose needed to achieve clearance, percentage of patients remaining in remission at 6 months, and side effects were analyzed. Results. Within 5–14 weeks (15–42 sessions), using cumulative narrowband-UVB dose ranging from 17.3 to 48.2?J/cm2, complete remission was achieved in 76.4% of patients. The rest of the patients achieved partial remission. Six months after discontinuation of the treatment, 42.8% of patients with complete remission remained in remission. Transient erythema in 11.1% of patients and mild hyperpigmentation in 14.8% of patients were the only side effects encountered during this study. Conclusion. We conclude that narrowband-UVB phototherapy is safe and effective for the treatment of early stage cutaneous T-cell lymphoma in darker-skinned patients. 1. Introduction Cutaneous T-cell lymphoma (CTCL) is a group of lymphoproliferative disorders with clonal expansion of T helper cells, or rarely T suppressor/killer cells or NK cells, with localization to the skin. This group is characterized by an increased CD4+ cells: CD4/CD8 > 10, and/or an expansion of T cells with a loss of 1 or more of the normal T-cell antigens (CD2, CD3, and CD5) [1]. Cutaneous T-cell lymphomas are very rare, with a prevalence of 5/1000000 per year [1, 2]. They are classified into a group with indolent clinical behavior, which includes mycosis fungoides (MF) and its variants (62%), and primary cutaneous CD30+ lymphoproliferative disorders (26%) and a group with aggressive clinical behavior (12%) like Sézary syndrome and adult T-cell leukemia/lymphoma [2]. MF, the commonest form of CTCL, presents as patches and plaques over trunk and proximal extremities, without internal involvement. It has a predilection for older adults and male gender [3–5]. MF is classified into early (stage IA, IB, and IIA) and advanced (stage IIB, III and IV) stages [2, 3]. In early stages, the

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