Sézary syndrome and seronegative polyarthritis: Treatment with extracorporeal photochemotherapy
We describe a patient with therapy-resistant cutaneous T-cell lymphoma, Sézary syndrome variant, in association with concurrent polyarthritis and vitiligo, who was successfully treated with extracorporeal photochemotherapy (ECP). The combination of Sézary syndrome with seronegative rheumatoid arthri...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2003-02, Vol.48 (2), p.220-226 |
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| container_title | Journal of the American Academy of Dermatology |
| container_volume | 48 |
| creator | Macheiner, Walter Jantschitsch, Christian Graninger, Winfried Pálóczy, Katalin Bálint, Géza Marschalkó, Márta Kainberger, Franz Breier, Friedrich Knobler, Robert M. |
| description | We describe a patient with therapy-resistant cutaneous T-cell lymphoma, Sézary syndrome variant, in association with concurrent polyarthritis and vitiligo, who was successfully treated with extracorporeal photochemotherapy (ECP). The combination of Sézary syndrome with seronegative rheumatoid arthritis is rare. In our patient the T-cell lymphoma was refractory to standard treatments that included psoralen—UVA, lymph node irradiation, and polychemotherapy. ECP has been shown to be effective in the treatment of selected cases of Sézary syndrome. There is a strong suggestion that ECP as a monotherapy can provide a significant benefit for other T-cell-mediated diseases including rheumatoid arthritis. In spite of a disease duration of 10 years, a very low CD8 cell count (2% of lymphocytes), a very high CD4 cell count (94%), and multiple unsuccessful chemotherapeutic trials before initiation of ECP, our patient achieved a long-lasting complete remission of both diseases with normalization of the CD4
+ and CD8
+ T-lymphocyte subsets. Concurrent developing vitiligo was unaffected by ECP. (J Am Acad Dermatol 2003;48:220-6.) |
| doi_str_mv | 10.1067/mjd.2003.11 |
| format | Article |
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+ and CD8
+ T-lymphocyte subsets. Concurrent developing vitiligo was unaffected by ECP. (J Am Acad Dermatol 2003;48:220-6.)</description><subject>Arthritis - complications</subject><subject>Arthritis - diagnostic imaging</subject><subject>Arthritis - drug therapy</subject><subject>Arthritis - immunology</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>CD4-Positive T-Lymphocytes</subject><subject>CD8-Positive T-Lymphocytes</subject><subject>Dermatology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lymphocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Photopheresis</subject><subject>Radiography</subject><subject>Sezary Syndrome - complications</subject><subject>Sezary Syndrome - drug therapy</subject><subject>Sezary Syndrome - immunology</subject><subject>Skin Neoplasms - complications</subject><subject>Skin Neoplasms - drug therapy</subject><subject>Skin Neoplasms - immunology</subject><subject>Tumors of the skin and soft tissue. Premalignant lesions</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0cFO3DAQBmCroipb2hN3lAvcsoztbBz3ViFoKyFxKD27E2dCjJI42F7a5Y36HH2xGrEVp5FGn2Y08zN2zGHNoVbn0323FgByzfkbtuKgVVmrRh2wFXANpa6FOGTvY7wHAF1J9Y4dcrFphNRixX5-__vnCcOuiLu5C36iAueuiBT8THeY3CMVix93GNIQXHLxU3EbCNNEcyp-uTQU9DsFtD4sPvfHYhl88nagyaeBAi67D-xtj2Okj_t6xH5cXd5efC2vb758u_h8XZJoZColdQTYt1oB6qoXGkFUsoJKd7putOQW-r7tlWihrnGDbc-bFnijM-YSSB6xs5e5S_APW4rJTC5aGkecyW-jURIkKJAZnuzhtp2oM0twU36A-f-TDE73AKPFsQ84WxdfXbXRea_KbvPiKJ_16CiYaB3NljoXyCbTeWc4mOeMTM7IPGdkOJf_ACOBhRU</recordid><startdate>20030201</startdate><enddate>20030201</enddate><creator>Macheiner, Walter</creator><creator>Jantschitsch, Christian</creator><creator>Graninger, Winfried</creator><creator>Pálóczy, Katalin</creator><creator>Bálint, Géza</creator><creator>Marschalkó, Márta</creator><creator>Kainberger, Franz</creator><creator>Breier, Friedrich</creator><creator>Knobler, Robert M.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20030201</creationdate><title>Sézary syndrome and seronegative polyarthritis: Treatment with extracorporeal photochemotherapy</title><author>Macheiner, Walter ; Jantschitsch, Christian ; Graninger, Winfried ; Pálóczy, Katalin ; Bálint, Géza ; Marschalkó, Márta ; Kainberger, Franz ; Breier, Friedrich ; Knobler, Robert M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e283t-3ede0afb970a94f29a02434049d968931c0ffbf72b066a5abf18b018994f130e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Arthritis - complications</topic><topic>Arthritis - diagnostic imaging</topic><topic>Arthritis - drug therapy</topic><topic>Arthritis - immunology</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>CD4-Positive T-Lymphocytes</topic><topic>CD8-Positive T-Lymphocytes</topic><topic>Dermatology</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lymphocyte Count</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Photopheresis</topic><topic>Radiography</topic><topic>Sezary Syndrome - complications</topic><topic>Sezary Syndrome - drug therapy</topic><topic>Sezary Syndrome - immunology</topic><topic>Skin Neoplasms - complications</topic><topic>Skin Neoplasms - drug therapy</topic><topic>Skin Neoplasms - immunology</topic><topic>Tumors of the skin and soft tissue. Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Macheiner, Walter</creatorcontrib><creatorcontrib>Jantschitsch, Christian</creatorcontrib><creatorcontrib>Graninger, Winfried</creatorcontrib><creatorcontrib>Pálóczy, Katalin</creatorcontrib><creatorcontrib>Bálint, Géza</creatorcontrib><creatorcontrib>Marschalkó, Márta</creatorcontrib><creatorcontrib>Kainberger, Franz</creatorcontrib><creatorcontrib>Breier, Friedrich</creatorcontrib><creatorcontrib>Knobler, Robert M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Macheiner, Walter</au><au>Jantschitsch, Christian</au><au>Graninger, Winfried</au><au>Pálóczy, Katalin</au><au>Bálint, Géza</au><au>Marschalkó, Márta</au><au>Kainberger, Franz</au><au>Breier, Friedrich</au><au>Knobler, Robert M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sézary syndrome and seronegative polyarthritis: Treatment with extracorporeal photochemotherapy</atitle><jtitle>Journal of the American Academy of Dermatology</jtitle><addtitle>J Am Acad Dermatol</addtitle><date>2003-02-01</date><risdate>2003</risdate><volume>48</volume><issue>2</issue><spage>220</spage><epage>226</epage><pages>220-226</pages><issn>0190-9622</issn><eissn>1097-6787</eissn><coden>JAADDB</coden><abstract>We describe a patient with therapy-resistant cutaneous T-cell lymphoma, Sézary syndrome variant, in association with concurrent polyarthritis and vitiligo, who was successfully treated with extracorporeal photochemotherapy (ECP). The combination of Sézary syndrome with seronegative rheumatoid arthritis is rare. In our patient the T-cell lymphoma was refractory to standard treatments that included psoralen—UVA, lymph node irradiation, and polychemotherapy. ECP has been shown to be effective in the treatment of selected cases of Sézary syndrome. There is a strong suggestion that ECP as a monotherapy can provide a significant benefit for other T-cell-mediated diseases including rheumatoid arthritis. In spite of a disease duration of 10 years, a very low CD8 cell count (2% of lymphocytes), a very high CD4 cell count (94%), and multiple unsuccessful chemotherapeutic trials before initiation of ECP, our patient achieved a long-lasting complete remission of both diseases with normalization of the CD4
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| subjects | Arthritis - complications Arthritis - diagnostic imaging Arthritis - drug therapy Arthritis - immunology Biological and medical sciences CD4 Lymphocyte Count CD4-Positive T-Lymphocytes CD8-Positive T-Lymphocytes Dermatology Hematologic and hematopoietic diseases Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphocyte Count Male Medical sciences Middle Aged Photopheresis Radiography Sezary Syndrome - complications Sezary Syndrome - drug therapy Sezary Syndrome - immunology Skin Neoplasms - complications Skin Neoplasms - drug therapy Skin Neoplasms - immunology Tumors of the skin and soft tissue. Premalignant lesions |
| title | Sézary syndrome and seronegative polyarthritis: Treatment with extracorporeal photochemotherapy |
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