Italian expert opinion on the treatment of mycosis fungoides with chlormethine gel: Results of a Delphi consensus

Abstract

Background

Mycosis fungoides (MF) is the most common form of a rare cutaneous T-cell lymphoma, often present with patches or plaques on the skin and characterized of malignant T cell infiltration. Topical Chlormethine (CL) gel has been approved by EMA for treatment of adult patients with MF. In clinical practice, chlormethine (CL) gel is often combined with other skin-directed or systemic therapies to optimize response and target recalcitrant lesions.

Objective

Increase knowledge, identify and discuss the use of CL gel on MF lesions in clinical practice with the aim of improving patients health-related quality of life (QoL).

Method

in the present study a modified Delphi methodology is used. A panel of 7 experts (the Scientific Board) was selected to identify 22 statements to be voted by the extended panel (28 expert Italian dermatologists or haematologists) and consensus was reached on most of the points discussed.

Results

In case of early stages of the disease, it was stated that although the use of CL gel is recommended in stages IA-IIA. The panel agreed in supporting the tolerability of CL gel in combination with other topical or systemic therapies, paying attention to the type of lesion treated (stage) and emphasizing the fact that it is a very useful treatment for persistent or refractory lesions. It was also stated by the panel that maintenance therapy after a partial response is suggested until complete remission. Finally, the experts unanimously support how CL gel is characterized by speed of action and flexibility in its application and also has safety features in cases of early and advanced lesions, giving to the patient an improvement of Quality of Life.