14 research outputs found
Clinical and laboratory experience of vorinostat (suberoylanilide hydroxamic acid) in the treatment of cutaneous T-cell lymphoma
The most common cutaneous T-cell lymphomas (CTCLs) â mycosis fungoides (MF) and SĂ©zary Syndrome â are characterised by the presence of clonally expanded, skin-homing helper-memory T cells exhibiting abnormal apoptotic control mechanisms. Epigenetic modulation of genes that induce apoptosis and differentiation of malignant T cells may therefore represent an attractive new strategy for targeted therapy for T-cell lymphomas. In vitro studies show that vorinostat (suberoylanilide hydroxamic acid or SAHA), an oral inhibitor of class I and II histone deacetylases, induces selective apoptosis of malignant CTCL cell lines and peripheral blood lymphocytes from CTCL patients at clinically achievable doses. In a Phase IIa clinical trial, vorinostat therapy achieved a meaningful partial response (>50% reduction in disease burden) in eight out of 33 (24%) patients with heavily pretreated, advanced refractory CTCL. The most common major toxicities of oral vorinostat therapy were fatigue and gastrointestinal symptoms (diarrhoea, altered taste, nausea, and dehydration from not eating). Thrombocytopenia was dose limiting in patients receiving oral vorinostat at the higher dose induction levels of 300âmg twice daily for 14 days. These studies suggest that vorinostat represents a promising new agent in the treatment of CTCL patients. Additional studies are underway to define the exact mechanism (s) of by which vorinostat induces selective apoptosis in CTCL cells and to further evaluate the antitumour efficacy of vorinostat in a Phase IIb study in CTCL patients
A descriptive study of black women with and without hair loss and their perception of dermatologists
Micose fungĂłide: estudo epidemiolĂłgico de 17 casos e avaliação da resposta terapĂȘutica Ă PUVA Mycosis fungoides: epidemiologic study of 17 cases and evaluation of PUVA photochemotherapy
FUNDAMENTOS: A fotoquimioterapia com PUVA Ă© indicada para tratamento da micose fungĂłide, empregada como monoterapia em estĂĄgios precoces ou combinada a outras drogas nos estĂĄgios mais avançados da doença. OBJETIVOS: Avaliação da resposta terapĂȘutica Ă fotoquimioterapia PUVA em pacientes com micose fungĂłide. MĂTODOS: Entre janeiro de 1996 e novembro de 2003 avaliaram-se 17 pacientes com micose fungĂłide no setor de Fototerapia da ClĂnica DermatolĂłgica da Santa Casa de SĂŁo Paulo. A terapia com PUVA foi realizada como monoterapia nos estĂĄdios iniciais ou como coadjuvante nos estĂĄdios avançados da doença. Avaliou-se o resultado do tratamento quanto ao aspecto clĂnico das lesĂ”es e parĂąmetros histolĂłgicos apĂłs tratamento. RESULTADOS: Quatorze de 16 pacientes responderam Ă fotoquimioterapia. Relacionando o estadiamento da doença Ă resposta terapĂȘutica obteve-se o seguinte: cinco pacientes (um em estĂĄgio IA e quatro em IB) com controle total (cura das lesĂ”es); quatro (todos IB) com melhora intensa (controle de 70-99%); dois (IIB e IVA) com melhora moderada (de 50 a 69%); trĂȘs (IA, IB, IIA) com melhora discreta (menos 50%); dois (IB, IIB) inalterados (sem resposta). Um paciente teve de descontinuar o tratamento por apresentar intenso ardor. CONCLUSĂO: Houve resposta Ă terapia PUVA em 87% dos pacientes, com controle total ou melhora intensa da doença em 56% dos casos. Sua efetividade permitiu regressĂŁo das lesĂ”es cutĂąneas, principalmente nos casos precoces. A fotoquimioterapia com PUVA mostrou ser tratamento seguro e efetivo, devendo ser considerado em pacientes com micose fungĂłide.<br>BACKGROUND: PUVA photochemotherapy is indicated to treat mycosis fungoides, either as monotherapy in the earlier stages of the disease or in combination with other drugs in more advanced stages of evolution. OBJECTIVES: To evaluate PUVA photochemotherapy response in patients with mycosis fungoides. METHODS: From January 1996 to November 2003, 17 patients with a diagnosis of mycosis fungoides were seen in the Dermatological Phototherapy Division of Santa Casa de Sao Paulo, Brazil. PUVA treatment was carried out as monotherapy at early stages of evolution and in combination with other treatments in more advanced cases of mycosis fungoides. The treatment response was evaluated regarding cutaneous clinical and histological improvement. RESULTS: Fourteen of 16 patients improved after PUVA. The rate of improvement in skin after treatment related to the initial stage of disease presented as follows: five patients (one in stage IA and four in IB) had total control (cure of lesions); four (all IB) had major regression (improvement of 70%-99%); two (IIB and IVA) had moderated improvement (50%-69%); three (IA, IB, IIA) had mild regression (less than 50%); two (IB, IIB) were unaltered. Only one patient had to discontinue treatment due to intense burning. CONCLUSION: Eighty-seven percent patients responded to PUVA therapy, and 56% presented total control or significant improvement of lesions. The effectiveness of treatment resulted in regression of lesions mainly in early stage cases. PUVA photochemotherapy was a successful and safe treatment, making it a good choice for patients with mycosis fungoides