Chart review study of real-world clinical outcomes in patients with cutaneous T-cell lymphoma treated with extracorporeal photopheresis in the US in 2017–2019

Figures & data

Table 1. Patient demographics and baseline clinical characteristics.

	Patients (N = 52)
Male, N (%)	26 (50.0%)
Current age (years), mean (SD)	69.4 (13.9)
Race, N (%)
White/Caucasian	44 (84.6%)
Black/African	7 (13.5%)
Unknown/Not documented	1 (1.9%)
Healthcare coverage, N (%)
HMO	4 (7.7%)
Medicare	28 (53.8%)
PPO	1 (1.9%)
Medicaid	3 (5.8%)
VA	2 (3.8%)
Other	23 (44.2%)
Body mass index, mean (SD)	28.22 (6.09)
Charlson Comorbidity Index, N (%)
0	41 (78.8%)
1	5 (9.6%)
2	4 (7.7%)
3+	2 (3.8%)
Comorbidities, N (%)
Hypertension	16 (30.8%)
Congestive heart failure	3 (5.8%)
Peripheral neuropathy	2 (3.8%)
Chronic pulmonary disease	4 (7.7%)
Renal disease	2 (3.8%)
Diabetes with complications	1 (1.9%)
Other	32 (61.5%)
Unknown/Not documented	2 (3.8%)
Age at CTCL diagnosis (years), mean (SD)	64.1 (14.4)
Disease stage at diagnosis, N (%)
IA	3 (5.8%)
IB	11 (21.2%)
IIA	2 (3.8%)
IIB	2 (3.8%)
III	8 (15.4%)
IVA	16 (30.8%)
IVB	5 (9.6%)
Unknown	5 (9.6%)
Subtype, N (%)
Mycosis fungoides	19 (36.5%)
Sezary syndrome	26 (50.0%)
Other	7 (13.5%)
Lymph node involvement at diagnosis, N (%)	17 (32.7%)
Extent of body surface area covered with plaque/patches at diagnosis (percentage), median (Q1 to Q3)	77.5 (25.0 to 90.0)
Median duration of prior therapies, months (Q1-Q3)	17.1 (8.2-31.5)
Primary rationale for ECP treatment, N (%)
Standard/recommended therapy	33 (63.5%)
Demonstrated/documented survival benefit	10 (19.2%)
Tolerability/safety profile	8 (15.4%)
Patient decision	1 (1.9%)
Prior therapies before ECP initiation, N (%)	N = 41^a
Bexarotene	14 (34.2%)
Methotrexate	9 (22.0%)
Interferon alpha	4 (9.8%)
Romidepsin	4 (9.8%)
Vorinostat	4 (9.8%)
Acitretin	2 (4.9%)
Belinostat	1 (2.4%)
Brentuximab vedotin	1 (2.4%)
Cyclophosphamide	1 (2.4%)
Isotretinoin	1 (2.4%)
Primary reason for ECP treatment discontinuation, N (%)	N = 44^a
Disease progression	16 (36.4%)
Maximum clinical benefit achieved	7 (15.9%)
Resistance to therapy	7 (15.9%)
Other	6 (13.6%)
Patient death	3 (6.8%)
Patient choice	2 (4.5%)
Drug toxicity/ adverse event	2 (4.5%)
Completed planned cycles	1 (2.3%)

^a Percentages reported by number of patients with recorded data.

Table 2. Response during ECP treatment.

	Patients (N = 52)
Response - at least 50% reduction in BSA affected, N (%)	19 (36.5%)
Time to response (months), median (Q1 to Q3)	6.5 (2.9 to 9.6)
Appearance of new skin lesions, N (%)	13 (25.0%)
Time to appearance of new skin lesions (months), median (Q1 to Q3)	5.9 (3.6 to 10.1)

BSA: body surface area; Q: quartile.

Table 3. Clinical outcomes during ECP treatment.

	Early Responders (up to 6 months of treatment)		Late Responders (9 months or more of treatment)
	After 3 months of treatment (N = 52)	After 6 months of treatment (N = 37)	After 9 months of treatment (N = 34)	After 12 months of treatment (N = 25)	After 18 months of treatment (N = 22)
Change in body surface area affected, N (%)
≥25% increase	2 (3.8%)	1 (2.7%)	0 (0.0%)	1 (4.0%)	1 (4.5%)
<25% increase to <25% decrease	31 (59.6%)	16 (43.2%)	12 (35.3%)	7 (28.0%)	4 (18.2%)
25-50% decrease	11 (21.2%)	10 (27.0%)	8 (23.5%)	4 (16.0%)	3 (13.6%)
51-75% decrease	6 (11.5%)	8 (21.6%)	7 (20.6%)	7 (28.0%)	6 (27.3%)
>75% decrease	1 (1.9%)	1 (2.7%)	5 (14.7%)	3 (12.0%)	6 (27.3%)
Not available	1 (1.9%)	1 (2.7%)	2 (5.9%)	3 (12.0%)	2 (9.1%)
Change in global assessment, N (%)
Very much improved	1 (1.9%)	1 (2.7%)	4 (11.8%)	2 (8.0%)	6 (27.3%)
Much improved	11 (21.2%)	12 (32.4%)	11 (32.4%)	9 (36.0%)	7 (31.8%)
Minimally improved	15 (28.8%)	9 (24.3%)	9 (26.5%)	4 (16.0%)	3 (13.6%)
No change	19 (36.5%)	11 (29.7%)	8 (23.5%)	5 (20.0%)	1 (4.5%)
Minimally worse	3 (5.8%)	3 (8.1%)	0 (0.0%)	2 (8.0%)	2 (9.1%)
Much worse	1 (1.9%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	1 (4.5%)
Very much worse	1 (1.9%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)
Not available	1 (1.9%)	1 (2.7%)	2 (5.9%)	3 (12.0%)	2 (9.1%)
Minimal/ much/ very much improved in body surface area	27 (52.9%)	22 (61.1%)	24 (75.0%)	15 (68.2%)	16 (80.0%)

Table 4. Laboratory outcomes during ECP treatment.

	After 3 months of treatment	After 6 months of treatment	After 9 months of treatment	After 12 months of treatment	After 18 months of treatment
CD4/CD8 ratio
N	28	22	20	15	15
Percent change,  median (Q1 to Q3)	−4.2 (−27.8 to 17.0)	−25.3 (−59.1 to 1.0)	−17.8 (−46.8 to 8.4)	−6.1 (−45.1 to 15.0)	0.0 (−42.9 to 36.2)
Total abnormal T-cells
N	18	13	12	10	10
Percent change, median (Q1 to Q3)	−20.3 (−40.3 to 12.5)	−60.4 (−72.1 to −32.7)	−58.1 (−71.2 to −35.8)	−59.9 (−77.3 to −22.9)	−61.1 (−100.0 to −6.6)
CD4 + CD7- cell count
N	23	19	19	15	15
Percent change, median (Q1 to Q3)	−0.1 (−15.4 to 35.6)	−16.7 (−36.7 to 11.5)	−26.3 (−50.0 to −6.0)	2.5 (−33.3 to 23.4)	−18.2 (−43.4 to 28.8)
CD4 + CD26- cell count
N	22	18	19	15	15
Percent change, median (Q1 to Q3)	−3.9 (−16.4 to 13.2)	−0.4 (−44.7 to 7.8)	−22.8 (−42.5 to −2.2)	−2.8 (−22.0 to 44.0)	−3.0 (−28.6 to 29.1)