Background: Most patients with erythrodermic cutaneous T-cell lymphoma (CTCL) have intense, generalized, refractory pruritus. In some large series the median survival was approximately 3 years. Objective: Our purpose was to review our experience with methotrexate in the treatment of 29 patients with erythrodermic CTCL observed for up to 129 months. Methods: This is a retrospective study. Data are presented in terms of response rates, freedom from treatment failure, and overall survival. Results: Twelve patients (41%) achieved complete remission, and five (17%) achieved partial remission for a total response rate of 58%. The median freedom from treatment failure was 31 months, and the median survival was 8.4 years. Side effects caused treatment failure in only two patients. Conclusion: Low-dose methotrexate is a valuable first-line treatment for the majority of patients with early to intermediate- stage erythrodermic CTCL.
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