Topical carmustine (BCNU) for mycosis fungoides and related disorders: a 10-year experience |
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Authors: | H S Zackheim E H Epstein N S McNutt D A Grekin W R Crain |
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Affiliation: | From the Departments of Dermatology and Pathology, New York University School of Medicine, and the Melanoma Cooperative Group, New York University Medical Centerm, New York, NY |
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Abstract: | A 10-year experience in eighty-six patients confirms the effectiveness of topical carmustine (BCNU) in mycosis fungoides (MF). Complete remission (CR) was achieved in 84% of those with less than 10% involvement (stage IA), median CR, 12 months, and in 52% with greater than 10% involvement (stage IB), median CR, 23 months. The probability of freedom from relapse for 1 year was 72% in stage IA and 37% in stage IB. No deaths in stages IA or IB were attributable to MF. Including all causes of death, the probability of 5-year survival for stage IA was 93% and for stage IB, 48%. Good results were obtained with only local BCNU in fourteen patients with mostly less than 5% involvement. Five of seven with poikilodermatous MF, two with parapsoriasis en plaques (PEP), and three with lymphomatoid papulosis did well. Persistent local therapy cleared deeply infiltrated lesions in some patients. With present schedules, the hazard of bone marrow depression is slight. Erythematous reactions and telangiectasia are troublesome but have not been accompanied by premalignant changes. |
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Keywords: | Reprint requests to: Dr. Alfred W. Kopf Skin and Cancer Unit 562 First Ave. New York NY 10016 |
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