Chlormethine Gel for Treatment of Patients with Mycosis Fungoides: Best Practices and Guidance to Clinicians.

IF 3.5 3区医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2024-11-27 DOI:10.1007/s13555-024-01305-x

Larisa Geskin, Christiane Querfeld, Emmilia Hodak, Neda Nikbakht, Evangelia Papadavid, Marco Ardigò, Ulrike Wehkamp, Martine Bagot

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Abstract

Background: Mycosis fungoides (MF) is the most common form of cutaneous T cell lymphoma. While multiple guidelines provide treatment recommendations, there are currently no clear treatment algorithms for MF. Chlormethine gel is recommended by major treatment guidelines as a first-line option for stage IA-IIA disease, and, on the basis of these guidelines, used in combination with other therapies in patients with advanced-stage MF in clinical practice.

Objectives: To provide guidance regarding the use of chlormethine gel for patients with all stages of MF, based on clinical expertise.

Methods: Opinions on best practices regarding the use of chlormethine gel were collected through discussions that involved eight clinicians with extensive experience in treating patients with MF.

Results: Chlormethine gel can be used as monotherapy in first- or second-line treatment of early-stage MF. In first-line, chlormethine gel monotherapy is prescribed for stage IA MF, and is particularly convenient for patients unable/unwilling to travel for hospital-based phototherapy, patients with thick plaques or palmoplantar involvement, when ultraviolet treatment is contraindicated, and for sanctuary sites. Chlormethine gel is also an appropriate first-line monotherapy for patients with stage IB or IIA MF; it may be used as part of combination regimens in these patients as well. For patients with late-stage MF, skin-directed treatments such as chlormethine gel should be combined with systemic therapies.

Conclusions: Chlormethine gel is a safe and effective treatment option that can be used in all stages of MF, either as monotherapy or in combination, depending on disease stage and patient characteristics and needs.

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治疗真菌病患者的氯甲胺凝胶：最佳实践与临床医师指南》。

背景：真菌病（MF）是最常见的皮肤T细胞淋巴瘤。虽然有多种指南提供治疗建议，但目前还没有明确的MF治疗算法。主要治疗指南推荐将氯雷他定凝胶作为IA-IIA期疾病的一线治疗方案，并根据这些指南在临床实践中与其他疗法联合用于晚期MF患者：根据临床专业知识，为各期骨髓纤维化患者使用氯甲胺凝胶提供指导：方法：通过八位在治疗骨髓纤维瘤患者方面具有丰富经验的临床医生参与的讨论，收集有关使用氯甲胺凝胶最佳实践的意见：结果：氯甲氧苄啶凝胶可作为单药用于早期MF的一线或二线治疗。在一线治疗中，氯甲胺凝胶单药可用于IA期的手足口病，对于无法/不愿前往医院接受光疗的患者、斑块较厚或掌跖受累的患者、紫外线治疗禁忌症患者以及禁区部位的患者尤为方便。甲氧苄啶凝胶也是 IB 期或 IIA 期 MF 患者的合适一线单药疗法；也可作为联合疗法的一部分用于这些患者。对于晚期 MF 患者，氯甲胺凝胶等皮肤导向疗法应与全身疗法相结合：氯甲胺凝胶是一种安全有效的治疗选择，可用于骨髓纤维瘤的各个阶段，根据疾病阶段、患者特点和需求，可作为单一疗法或联合疗法使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.