Extracorporeal photopheresis and adjuvant aerosolized granulocyte-macrophage colony-stimulating factor for Sézary syndrome

Saskia A. Bouwhuis, Svetomir Nenad Markovic, Marian T. McEvoy, Mark R. Pittelkow

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Encouraged by preliminary phase 1 studies of aerosolized granulocyte-macrophage colony-stimulating factor (GM-CSF, sargramostim) in the treatment of patients with melanoma and other malignancies, we treated a 72-year-old patient with Sézary syndrome, using alternate-week cycles of aerosolized GM-CSF in combination with monthly cycles of extracorporeal photopheresis (ECP). Sézary syndrome, one of the more aggressive forms of cutaneous T-cell lymphoma, is a devastating and highly symptomatic form of non-Hodgkin lymphoma in which malignant clones of mature helper CD4 T cells, containing large, convoluted nuclei known as Sézary cells, circulate in the blood and infiltrate skin. Extracorporeal photopheresis, an immunomodulatory therapy, has become a primary treatment for patients with Sézary syndrome. This pheresis-based therapy combines psoralen and ultraviolet A radiation as systemic photochemotherapy to induce immune responses. However, the activity and efficacy of ECP vary considerably. To our knowledge this is the first patient with Sézary syndrome treated with adjuvant aerosolized GM-CSF combined with ECP. It produced clinical improvement and decreased the number of circulating Sézary cells in a previously ECP-refractory patient.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalMayo Clinic Proceedings
Volume77
Issue number2
StatePublished - 2002

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Photopheresis
Granulocyte-Macrophage Colony-Stimulating Factor
PUVA Therapy
Cutaneous T-Cell Lymphoma
Blood Component Removal
Immunomodulation
Photochemotherapy
Helper-Inducer T-Lymphocytes
Non-Hodgkin's Lymphoma
Melanoma
Clone Cells
Radiation
Skin
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Extracorporeal photopheresis and adjuvant aerosolized granulocyte-macrophage colony-stimulating factor for Sézary syndrome. / Bouwhuis, Saskia A.; Markovic, Svetomir Nenad; McEvoy, Marian T.; Pittelkow, Mark R.

In: Mayo Clinic Proceedings, Vol. 77, No. 2, 2002, p. 197-200.

Research output: Contribution to journalArticle

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