Therapy of mycosis fungoides with bleomycin

A case of mycosis fungoides with universal plaque-like, dermal infiltration and severe generalized exfoliation is described. This patient had been treated with topical nitrogen mustard, occlusive steroid dressings, total body electron beam therapy, total body orthovoltage superficial radiotherapy, and intensive combination chemotherapy (cyclophosphamide, vincristine, prednisone) during the 6-year course of his disease, and had become refractory to all modalities. Bleomycin, a new antitumor antibiotic, was administered parenterally at a dose of 10 mg/m2 twice weekly. Over a period of 12 weeks a complete response was achieved and has been maintained 8+ months with a low dose weekly bleomycin and burst cyclophosphamide and prednisone therapy. Toxicity has been minimal. The postulated mechanism for the success of this drug in therapy of this disease entity is discussed.