Cutaneous T-Cell Lymphoma: A Paradigm for Biological Therapies
Cutaneous T-Cell Lymphoma: A Paradigm for Biological Therapies
复制标题
皮肤 T 细胞淋巴瘤：生物治疗的范例
作者：
D. Pichardo;C. Querfeld;J. Guitart;T. Kuzel;S. Rosen
蕈样肉芽肿和Sézary综合征是皮肤T细胞淋巴瘤最常见的类型。蕈样肉芽肿/Sézary综合征目前尚无标准治疗，一般倾向于依赖局部干预治疗早期疾病，延迟全身毒性更大的治疗，直至出现广泛症状。了解这种疾病的生物学特征，可以制定合理的干预措施，并在治疗方面取得重大进展。类维生素A在蕈样肉芽肿/Sézary综合征中具有活性，较新的rexinoids有局部和全身形式。干扰素α仍然是蕈样肉芽肿/Sézary综合征最有效的治疗药物之一，特别是与其他药物如PUVA联合使用。单克隆抗体Alemtuzumab在至少一半的晚期疾病患者中产生应答，其副作用特征主要包括免疫抑制和输注反应。重组IL 2-白喉毒素地尼白细胞介素diftitox（Ontak）在这种疾病中是活跃的，似乎在症状缓解和生活质量方面有有益的效果。体外光化学疗法作为一种免疫刺激干预似乎对一部分患者非常有效，但其可用性仅限于全球不到100个中心。实验和较少研究的干预措施包括自体和同种异体外周干细胞移植，白细胞介素-12，组蛋白脱乙酰缩肽和合成脱氧核苷酸CpG 7909。皮肤T细胞淋巴瘤已成为开发生物制剂的范例。进一步了解蕈样肉芽肿/Sézary综合征的信号通路将有助于开发更有效的治疗策略。
Mycosis Fungoides and Sézary Syndrome are the most common types of cutaneous T-cell lymphomas. There is no current standard of care for Mycosis Fungoides/Sézary Syndrome, with a general tendency to rely on topical interventions for early disease delaying systemic, more toxic therapy until the development of extensive symptoms. Knowledge of the biological characteristics of this disease has allowed for the development of rational interventions and a significant advance in its treatment. Retinoids are active in Mycosis Fungoides/Sézary Syndrome with the newer rexinoids being available in topical and systemic forms. Interferon alpha remains one of the most active therapeutic agents for Mycosis Fungoides/Sézary Syndrome, especially in combination with other agents such as PUVA. The monoclonal antibody alemtuzumab leads to responses in at least half of patients with advanced disease with its side effect profile consisting mainly of immunosupression and infusion reactions. The recombinant IL2-diphteria toxin denileukin diftitox (Ontak) is active in this disease and appears to have a beneficial effect in symptoms relief and quality of life. Extracorporeal photochemotherapy as an immunostimulating intervention seems to be very effective in a subset of patients, but its availability is limited to less than a hundred centers worldwide. Experimental and less studied interventions include autologous and allogeneic peripheral stem cell transplantation, Interleukin-12, the histone-deacetylator depsipeptide and the synthetic deoxynucleotide CpG7909. Cutaneous T-cell lymphoma has served as a paradigm for the development of biological agents. Further knowledge of the signaling pathways in Mycosis Fungoides/Sézary Syndrome will allow for the development of more effective treatment strategies.
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喷司他丁治疗难治性淋巴瘤和皮肤 T 细胞疾病的 II 期试验。
DOI：
10.1200/jco.1991.9.4.565
发表时间：
1991
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Cummings,FJ;Kim,K;Neiman,RS;Comis,RL;Oken,MM;Weitzman,SA;Mann,RB;O'Connell,MJ
通讯作者：
O'Connell,MJ
影响因子：
--
作者：
Youn H. Kim;Reini Jensen;Garrett L. Watanabe;A. Varghese;R. Hoppe
通讯作者：
Youn H. Kim;Reini Jensen;Garrett L. Watanabe;A. Varghese;R. Hoppe
影响因子：
45.3
作者：
Duvic, M;Hymes, K;Yocum, RC
通讯作者：
Yocum, RC
影响因子：
158.5
作者：
EDELSON, R;BERGER, C;LAROCHE, L
通讯作者：
LAROCHE, L
DOI：
--
发表时间：
2002-05
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Chunlei Zhang;P. Hazarika;X. Ni;D. Weidner;M. Duvic
通讯作者：
Chunlei Zhang;P. Hazarika;X. Ni;D. Weidner;M. Duvic