Quality-of-life improvements in cutaneous T-cell lymphoma patients treated with denileukin diftitox (ONTAK®)

Madeleine Duvic, Timothy M. Kuzel, Elise A. Olsen, Ann G. Martin, Francine M. Foss, Youn H. Kim, Peter W. Heald, Patricia Bacha, Jean Nichols, Astra Liepa

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

Cutaneous T-cell lymphoma (CTCL) can be associated with painful, pruritic, disfiguring lesions. As part of a multicenter, randomized phase III trial in patients with heavily pretreated advanced and/or recurrent CTCL, the effects of an interleukin-2 receptor-targeted fusion protein, denileukin diftitox (DAB389IL-2, ONTAK®), on patient-rated overall quality of life (QOL), skin appearance, and pruritus severity were evaluated. A total of 71 patients with stage IB-IVA CTCL received intravenous denileukin diftitox 9 μg/kg/day or 18 μg/kg/day over 15-60 minutes for 5 consecutive days on an outpatient basis; cycles were planned for every 21 days for a total of 8 cycles over 6 months. Prior to each treatment cycle, patients were evaluated for disease response and were asked to self-rate their overall QOL via the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, skin appearance (7-point scale), and pruritus severity (10-cm visual analogue scale). Composite FACT-G and most individual subscale scores (physical, social/family, emotional, and functional well being) in documented responders (n = 21) gradually increased during the study period, generally reaching statistical significance (P < 0.05) by cycle 3, and were significantly (P ≤ 0.041) higher than the scores of nonresponders at endpoint. Additionally for responders, assessments of skin severity and pruritus severity showed significant (P ≤ 0.05) improvements at study endpoint compared with baseline. Adverse transfusion-related events (eg, hypersensitivity reactions, flu-like syndrome) were common during cycles 1 and 2, and vascular-leak syndrome occurred in 25% of patients. Denileukin diftitox was not associated with any clinically significant myelosuppression. Heavily pretreated patients with advanced and/or recurrent CTCL who responded to denileukin diftitox therapy showed significant improvements in self-rated overall QOL, skin appearance, and pruritus severity.

Original languageEnglish
Pages (from-to)222-228
Number of pages7
JournalClinical Lymphoma
Volume2
Issue number4
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

Keywords

  • Cutaneous T-cell lymphoma
  • Denileukin diftitox
  • Fusion protein
  • Interleukin-2 receptor
  • Pruritus
  • Quality of life

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    Duvic, M., Kuzel, T. M., Olsen, E. A., Martin, A. G., Foss, F. M., Kim, Y. H., Heald, P. W., Bacha, P., Nichols, J., & Liepa, A. (2002). Quality-of-life improvements in cutaneous T-cell lymphoma patients treated with denileukin diftitox (ONTAK®). Clinical Lymphoma, 2(4), 222-228. https://doi.org/10.3816/CLM.2002.n.003