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Management of mycosis fungoides and Sézary syndrome with mogamulizumab in combination with psoralen plus UVA: two case reports  (2025)

Authors:
Bernardelli, Andrea; Visco, Carlo
Title:
Management of mycosis fungoides and Sézary syndrome with mogamulizumab in combination with psoralen plus UVA: two case reports
Year:
2025
Type of item:
Articolo in Rivista
Tipologia ANVUR:
Articolo su rivista
Language:
Inglese
Referee:
No
Name of journal:
THERAPEUTIC ADVANCES IN HEMATOLOGY
ISSN of journal:
2040-6207
N° Volume:
16
Page numbers:
165-175
Keyword:
Sézary syndrome; case report; combination therapy; cutaneous T-cell lymphoma; mogamulizumab; mycosis fungoides; psoralen plus UVA
Short description of contents:
: This report describes the cases of two patients with mycosis fungoides and Sézary syndrome (MF/SS) who achieved clinical benefit with mogamulizumab combination therapies. Case 1 is a 56-year-old male with stage IIIB (T4NxM0B1) MF, which later progressed into SS, with ongoing skin symptoms (erythema, lichenified skin, and pruritis) and axillary and inguinal lymphadenomegaly. Skin-directed and systemic therapies failed to achieve a long-lasting response in this patient. Mogamulizumab (1 mg/kg once weekly for 4 weeks; once every 2 weeks thereafter) yielded temporary improvement in skin symptoms, but progression in the skin was confirmed after ~2 months. Subsequently, the combination of mogamulizumab with psoralen plus ultraviolet light A (PUVA) yielded a partial response; however, PUVA was discontinued due to phototoxicity and mogamulizumab was continued as monotherapy. At the latest evaluation, clinical improvement in the skin and reduced lymphadenomegaly were evident with ongoing mogamulizumab monotherapy; the patient is awaiting allogeneic hematopoietic stem cell transplantation. Case 2 is an 80-year-old male with stage IIIB (T4NxM0B1) granulomatous variant MF who presented with diffuse erythema with desquamation, ectropion, and inguinal lymphadenopathy. Treatment with oral prednisone and bexarotene failed to achieve adequate, long-lasting responses. Mogamulizumab (1 mg/kg once weekly for 4 weeks; once every 2 weeks thereafter) monotherapy yielded an initial improvement, characterized by less intense erythema, but the improvement was not sustained. Mogamulizumab was supplemented with oral prednisone and then PUVA; this combination resulted in improvement in the skin. PUVA was stopped due to unavailability, and methotrexate (10 mg once weekly) was initiated alongside continued mogamulizumab; this led to improvement in erythema. The patient continued mogamulizumab plus methotrexate with improving clinical status, prior to their death, which was deemed to be unlikely to be related to treatment. Our experience suggests that, in principle, mogamulizumab can be used in combination with other therapies; however, further research is needed.
Product ID:
145945
Handle IRIS:
11562/1162809
Last Modified:
May 23, 2025
Bibliographic citation:
Bernardelli, Andrea; Visco, Carlo, Management of mycosis fungoides and Sézary syndrome with mogamulizumab in combination with psoralen plus UVA: two case reports «THERAPEUTIC ADVANCES IN HEMATOLOGY» , vol. 162025pp. 165-175

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo IRIS

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