Photodynamic Therapy in Treating Patients With Lymphoma or Chronic Lymphocytic Leukemia

OBJECTIVES:

• Determine the pain grade and epidermal toxic response (ETR) of patients with T-cell or B-cell lymphoma or early chronic lymphocytic leukemia with cutaneous infiltrates treated with photodynamic therapy using aminolevulinic acid.
• Determine the feasibility of maintaining a pain grade of 1 or less and an approximate ETR of 2 in patients receiving up to 12 sessions of this regimen.
• Determine the maximal irradiance and corresponding exposure among multiple treatments at the same site and among different sites in the same and in different patients.
• Determine the cumulative response achieved at the completion of treatment in these patients.
• Determine the number of sessions required to complete treatment in these patients.
• Correlate ETR with incremental treatment response in patients treated with this regimen.

OUTLINE: This is a randomized study. Patients' individual lesions are randomized to 1 of 3 treatment arms.

• Arm I: Patients receive a short duration of topical aminolevulinic acid (ALA) on the lesion and surrounding normal skin. The lesion is then illuminated with red light for up to 30 minutes.
• Arm II: Patients receive a medium duration of ALA followed by light illumination as in arm I.
• Arm III: Patients receive a long duration of ALA followed by light illumination as in arm I.

In all arms, treatment repeats every 2 weeks for up to 12 courses in the absence of unacceptable toxicity or progressive (systemic) disease.

Additional patients are accrued to a treatment arm if at least 2 of 3 patients on that arm experience 25% cumulative clinical response.

Patients are followed at 1, 3, and 6 months and then every 6 months for 2 years.

PROJECTED ACCRUAL: A total of 4-10 patients will be accrued for this study within 5-7 years.

DISEASE CHARACTERISTICS:

• One of the following histologically confirmed diagnoses:

• Cutaneous B-cell or T-cell lymphoma confined to the skin

• No evidence of internal disease other than peripheral adenopathy
• Early chronic lymphocytic leukemia with cutaneous B-cell infiltrates not requiring systemic therapy
• Stable or slowly progressive disease that is not expected to substantially change during treatment

PATIENT CHARACTERISTICS:

Age

• Not specified

Performance status

• Not specified

Life expectancy

• Not specified

Hematopoietic

• Not specified

Hepatic

• Not specified

Renal

• Not specified

Other

• Not pregnant or nursing
• No porphyria or known hypersensitivity to porphyrins
• No known photosensitivity diseases

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Concurrent clinically necessary interferon alfa allowed

Chemotherapy

• No concurrent systemic multiagent chemotherapy

Endocrine therapy

• Not specified

Radiotherapy

• No concurrent local radiotherapy to study lesions
• No concurrent whole body radiotherapy

Surgery

• Not specified

Other

• More than 1 month since prior topical therapy to study lesions
• Concurrent topical therapy to non-study lesions allowed