PB1829 SEZARY SYNDROME TREATMENT AND OTHER T-CELL CUTANEOUS LYMPHOMAS WITH EXTRACORPOREAL PHOTOPHERESIS: RESULTS FROM 157 PROCEDURES IN ELEVEN PATIENTS IN COLOMBIA
Authors: L. Enciso-Olivera, B. Patiño, H. Martinez, J. Arenas, M. Diaz, D. Otero, P. Spirko, C. Acon
Journal: HemaSphere (2019)

Background: Cutaneous lymphomas are a heterogenic group of disease which affects primarily the skin. Its incidence has been estimated in 10 to 10.7 per million of people-year and represents 19% of extranodal lymphomas. The erythrodermic Mycosis fungoides (MF) and Sezary syndrome (SS) have a poor response to treatments based on conventional chemotherapy and the patient survival in advance stage of disease at 15 years has been reported near 10%. The monoclonal cells extracorporeal exposure to UV light, after of the administration of a sensitizer agent (8-MOP) is active, well tolerated and have been reported high response rates in patients with MF/SS and three patients with CGVH disease treated in our center. Aims: To describe the clinical features, pathologic and results of procedures of extracorporeal photopheresis (ECP) in eight patients with SS and MF erythrodermic and three patients with CGVH disease in the only center with ECP available in Colombia. Methods: This is a descriptive study, type case series gathered the clinical features, pathologic and results of 151 procedures of extracorporeal photopheresis (ECP) in eight patients with SS and MF erythrodermic and three patients with CGVH disease. The evaluation of involvement severity by MF/SS was assessed by the Modified Severity-Weighted Assessment (MSWAT) and the response definitions were described at the consensus criteria. Results: The median age was 54 years for women and 69 for men, being the difference statistically significant (Mann-Whitney p = 0.02). Five (63%) out of eight patients with diagnostic of cutaneous lymphoma, had a SS diagnostic. The diagnostic and stratification distribution are showed in Figure 1 and 2. The median treatment lines received before the ECP beginning was two (0 to 4). All the patients were admitted in progressive disease. A total of 157 ECP seasons were performed to 11 patients. The peripheral vein access was obtained in 115 procedures (73.25%) and central vein access in the remaining procedures. In 156 seasons (99.36%), the procedure was by a unique vein puncture. The duration of all procedure was 1.98 hours for all the group, being greater in the procedures performed by peripheral vein access (Figure 3). The time of photoactivation was in mean 26 minutes with a minimum of 6 minutes and maximum of 51 minutes with a positive correlation between the volume of treatment and the time (Figure 4. [Rho Spearman 0.31; P = 0.0001]). The reduction in the mSWAT was in a mean of 76 points for the whole cohort, being of 173.83 points greater in the patients with a complete response. Six patients had an improvement of pruritus and two cases were stable. The complications related to vein access was the most frequent.Summary/Conclusion: This results showed the first national experience in Colombia with the ECP treatment. The procedure is safe and well tolerated, with a promise results in a population highly treated and refractory to the prior therapies.