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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2000 April;135(2):237-41

language: Italian

Topical treatment of mycosis fungoides with mechlorethamine. Therapeutic experiences

Passarini B., Bandini P., Costa A. M., Varotti C.

Università degli Studi - Bologna Dipartimento di Medicina Clinica Specialistica e Sperimentale Sezione di Clinica Dermatologica (Direttore: Prof. C. Varotti)


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Background. The experience with treatment of Mycosis Fungoides (MP) with topical mechlorethamine is reported. The mechlorethamine is an alkylating agent acting on fast reproducing cells and particularly on lymphocytes. It has been already used since 1947 (Goodman and Gilman) to treat cutaneous T-cell lymphoma: it is only in early sixties that Richardson and Haserik used it topically with very good results in a patient affected by MF. Thereafter, many positive experiences made such drug the elective treatment for early stage MF.
Methods. This trial with mechlorethamine was conducted on a limited number of patients (6), 4 males and 2 females, a complete remission was obtained in 2 patients (33%); a remission above 50% was reported in 3 patients (50%) and 1 patient had a remission lower than 25% (16,5%).
Results. Side-effects were reported in 4 out of 6 patients, presenting more or less severe DIC and/or DAC, but never at a level to suspend the therapy. A maintenance protocol every 10-14 days was needed to keep the remissions.
Conclusions. Mechlorethamine. which has very limited side-effects, without contraindication nor dose limit, is a valid topical drug treatment of MF, improving life conditions and increasing patients survival.

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