2024
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
Girardi M, Carlson K, Huang X, Corman S, Edmundson P, Schmier J, Kale H, Raina R, Foss F. 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. Journal Of Dermatological Treatment 2024, 35: 2360568. PMID: 38852942, DOI: 10.1080/09546634.2024.2360568.Peer-Reviewed Original ResearchConceptsCutaneous T-cell lymphomaCutaneous T-cell lymphoma patientsExtracorporeal photopheresisResponse rateClinical outcomesMonths of ECP treatmentMedian time to responseReal-world treatment patternsECP initiationLymph node involvementStage IV diseaseAdvanced-stage diseaseT-cell lymphomaTime to responseEffective treatment optionPercentage of patientsChart review studyIV diseaseSezary syndromeNode involvementConcomitant therapySystemic therapyMedian ageMycosis fungoidesChart reviewAllogeneic transplantation and cellular therapies in cutaneous T-cell lymphoma
Goyal A, Foss F. Allogeneic transplantation and cellular therapies in cutaneous T-cell lymphoma. Expert Review Of Anticancer Therapy 2024, 24: 41-58. PMID: 38224371, DOI: 10.1080/14737140.2024.2305356.Peer-Reviewed Original ResearchConceptsDonor lymphocyte infusionTotal body irradiationT-cell lymphomaCAR-T cell therapyCutaneous T-cell lymphomaT-cell therapySezary syndromeAllo-HSCTT cellsLymphocyte infusionCAR-TMycosis fungoidesAllogeneic hematopoietic stem cell transplantationCAR-T cell persistenceReduced-intensity conditioning regimensHematopoietic stem cell transplantationAdvanced stage MFTemporary disease controlTreatment of MF/SSCAR-T therapyInduce complete remissionCurative treatment optionStem cell transplantationNonmalignant T cellsTime of transplantation
2023
Allogeneic stem cell transplant for treatment of mycosis fungoides and Sezary syndrome: a systematic review and meta-analysis
Goyal A, O’Leary D, Foss F. Allogeneic stem cell transplant for treatment of mycosis fungoides and Sezary syndrome: a systematic review and meta-analysis. Bone Marrow Transplantation 2023, 59: 41-51. PMID: 37853164, DOI: 10.1038/s41409-023-02122-0.Peer-Reviewed Original ResearchConceptsGraft-versus-host diseaseReduced-intensity conditioningDonor lymphocyte infusionAllo-HSCTStem cell transplantationMyeloablative conditioningSezary syndromeOverall survivalMycosis fungoidesCell transplantationRates of graft-versus-host diseaseTreated with donor lymphocyte infusionsChronic graft-versus-host diseaseAllogeneic hematopoietic stem cell transplantationMeta-analysisAdvanced-stage mycosis fungoidesAssociated with superior OSGraft-versus-lymphoma effectOutcomes of allo-HSCTAllogeneic stem cell transplantationHematopoietic stem cell transplantationTreatment of mycosis fungoidesGraft-versus-lymphomaNon-relapse mortalityProgression-free survival
2022
Primary cutaneous lymphoma: recommendations for clinical trial design and staging update from the ISCL, USCLC, and EORTC
Olsen EA, Whittaker S, Willemze R, Pinter-Brown L, Foss F, Geskin L, Schwartz L, Horwitz S, Guitart J, Zic J, Kim YH, Wood GS, Duvic M, Ai W, Girardi M, Gru A, Guenova E, Hodak E, Hoppe R, Kempf W, Kim E, Lechowicz MJ, Ortiz-Romero P, Papadavid E, Quaglino P, Pittelkow M, Prince HM, Sanches JA, Sugaya M, Vermeer M, Zain J, Knobler R, Stadler R, Bagot M, Scarisbrick J. Primary cutaneous lymphoma: recommendations for clinical trial design and staging update from the ISCL, USCLC, and EORTC. Blood 2022, 140: 419-437. PMID: 34758074, PMCID: PMC9353153, DOI: 10.1182/blood.2021012057.Peer-Reviewed Original ResearchConceptsPrimary cutaneous lymphomasNon-Hodgkin lymphomaCutaneous lymphomasMycosis fungoides/Sézary syndromeCutaneous Lymphoma Task ForceInvestigator-initiated trialPotential prognostic factorsNumber of patientsClinical trial guidelinesClinical trial designExtracutaneous diseaseSézary syndromePrognostic factorsTreatment of cancerTrials guidelinesClinical trialsComparative efficacyTrial designNumber of subtypesEuropean OrganizationNew treatmentsLymphomaResponse criteriaTherapeutic agentsStudy design
2021
New nonchemotherapy treatment options for cutaneous T-cell lymphomas
Xu S, Foss F. New nonchemotherapy treatment options for cutaneous T-cell lymphomas. Expert Review Of Anticancer Therapy 2021, 21: 1017-1028. PMID: 33554707, DOI: 10.1080/14737140.2021.1882859.Peer-Reviewed Original ResearchMeSH KeywordsDisease ProgressionHumansLymphoma, T-Cell, CutaneousMycosis FungoidesSezary SyndromeSkin NeoplasmsConceptsMF/Sézary syndromeSézary syndromeMycosis fungoidesTreatment optionsNovel agentsCutaneous T-cell lymphomaCAR T-cell therapyAdditional novel agentsT-cell lymphomaT-cell therapyAntibody-based therapiesHistone deacetylase inhibitorsConventional chemotherapy approachesCheckpoint inhibitorsImmunomodulatory treatmentBrentuximab vedotinSystemic therapyAntibody agentsComplete responseLymph nodesTreatment armamentariumT cellsChemotherapy approachesImmune effectorsSmall molecule inhibitorsHow we treat advanced stage cutaneous T‐cell lymphoma – mycosis fungoides and Sézary syndrome
Sethi TK, Montanari F, Foss F, Reddy N. How we treat advanced stage cutaneous T‐cell lymphoma – mycosis fungoides and Sézary syndrome. British Journal Of Haematology 2021, 195: 352-364. PMID: 33987825, DOI: 10.1111/bjh.17458.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsAdrenal Cortex HormonesAgedAntibodies, MonoclonalAntineoplastic AgentsBexaroteneBiomarkers, TumorClinical Trials as TopicCombined Modality TherapyDelayed DiagnosisDiagnosis, DifferentialElectronsHematopoietic Stem Cell TransplantationHistone Deacetylase InhibitorsHumansInterferon-alphaMaleMycosis FungoidesNeoplasm StagingNeoplastic Stem CellsPhotopheresisPrognosisPUVA TherapyRetinoidsSezary SyndromeSignal TransductionSkin NeoplasmsT-Lymphocyte SubsetsConceptsT-cell lymphomaSézary syndromeMultidisciplinary careCutaneous T-cell lymphoma mycosis fungoidesMycosis fungoides/Sézary syndromeCutaneous T-cell lymphomaLines of therapyAdditional treatment optionsNon-Hodgkin lymphomaDuration of useCumulative drug toxicityEarly referralRecurrent diseaseDiagnostic delayPatients' qualityTreatment optionsCommon subtypeTreatable diseaseRare subsetDrug toxicityLymphomaSyndromeDiseasePresent reviewCare
2020
Outcomes for allogeneic stem cell transplantation in refractory mycosis fungoides and primary cutaneous gamma Delta T cell lymphomas
Isufi I, Seropian S, Gowda L, Wilson LD, Roberts K, Girardi M, Perreault S, Foss F. Outcomes for allogeneic stem cell transplantation in refractory mycosis fungoides and primary cutaneous gamma Delta T cell lymphomas. Leukemia & Lymphoma 2020, 61: 2955-2961. PMID: 32643494, DOI: 10.1080/10428194.2020.1790555.Peer-Reviewed Original ResearchConceptsAllogeneic stem cell transplantationMF/SSTime of transplantStem cell transplantationT-cell lymphomaMedian followCell transplantationCell lymphomaPrimary cutaneous gamma-delta T-cell lymphomaCutaneous gamma-delta T-cell lymphomaGamma-delta T-cell lymphomaMF/SS patientsLong-term complete responseCutaneous T-cell lymphomaTotal skin electron beamRefractory mycosis fungoidesClinical complete remissionDisease-free survivalComplete remissionOverall survivalPartial responseSkin involvementComplete responseMycosis fungoidesSS patients
2019
Pembrolizumab in Relapsed and Refractory Mycosis Fungoides and Sézary Syndrome: A Multicenter Phase II Study.
Khodadoust MS, Rook AH, Porcu P, Foss F, Moskowitz AJ, Shustov A, Shanbhag S, Sokol L, Fling SP, Ramchurren N, Pierce R, Davis A, Shine R, Li S, Fong S, Kim J, Yang Y, Blumenschein WM, Yearley JH, Das B, Patidar R, Datta V, Cantu E, McCutcheon JN, Karlovich C, Williams PM, Subrahmanyam PB, Maecker HT, Horwitz SM, Sharon E, Kohrt HE, Cheever MA, Kim YH. Pembrolizumab in Relapsed and Refractory Mycosis Fungoides and Sézary Syndrome: A Multicenter Phase II Study. Journal Of Clinical Oncology 2019, 38: 20-28. PMID: 31532724, PMCID: PMC6943974, DOI: 10.1200/jco.19.01056.Peer-Reviewed Original ResearchConceptsRefractory mycosis fungoidesSézary syndromeOverall response rateMycosis fungoidesTreatment discontinuationFlare reactionAdvanced MF/SSResponse rateMF/Sézary syndromeMulticenter phase II studyMulticenter phase II trialSeverity-Weighted Assessment ToolHigh PD-1 expressionAdvanced mycosis fungoidesEfficacy of pembrolizumabPrior systemic therapySubsequent clinical responseAdvanced-stage diseasePhase II studyPrimary end pointPD-1 expressionPhase II trialFavorable safety profileTotal mutation burdenLack of response
2017
Annual Facility Treatment Volume and Patient Survival for Mycosis Fungoides and Sézary Syndrome
Kann BH, Park HS, Yeboa DN, Aneja S, Girardi M, Foss FM, Roberts KB, Wilson LD. Annual Facility Treatment Volume and Patient Survival for Mycosis Fungoides and Sézary Syndrome. Clinical Lymphoma Myeloma & Leukemia 2017, 17: 520-526.e2. PMID: 28655598, DOI: 10.1016/j.clml.2017.05.017.Peer-Reviewed Original ResearchConceptsMF/SSOverall survivalSézary syndromeHazard ratioImproved survivalMycosis fungoidesPatient survivalHighest quintileLowest quintileTreatment volumeImproved overall survivalMultivariable Cox regressionNational Cancer DatabaseKaplan-Meier methodAnnual patient volumeNational database analysisLog-rank testContinuous variablesMedian followMultivariable analysisCox regressionOS survivalCancer DatabasePatientsPatient volumeMycosis Fungoides and Sezary Syndrome
Foss FM, Girardi M. Mycosis Fungoides and Sezary Syndrome. Hematology/Oncology Clinics Of North America 2017, 31: 297-315. PMID: 28340880, DOI: 10.1016/j.hoc.2016.11.008.Peer-Reviewed Original ResearchMeSH KeywordsAllograftsHumansImmunologic FactorsMycosis FungoidesSezary SyndromeStem Cell TransplantationT-Lymphocytes, RegulatoryConceptsSkin-directed therapiesSezary syndromeLymph nodesMycosis fungoidesAllogeneic stem cell transplantationSystemic immunomodulatory agentsVisceral organ involvementSingle-agent chemotherapyStem cell transplantationPatch/plaqueHelper T cellsExtent of skinDiffuse erythrodermaBlood involvementOrgan involvementRefractory diseaseVisceral involvementResistant diseaseRare lymphomaCell transplantationImmunomodulatory agentsPlaque diseaseCurative strategiesT cellsDisease
2016
Cutaneous T-cell lymphoma (CTCL): Current practices in blood assessment and the utility of T-cell receptor (TCR)-Vβ chain restriction
Gibson JF, Huang J, Liu KJ, Carlson KR, Foss F, Choi J, Edelson R, Hussong JW, Mohl R, Hill S, Girardi M. Cutaneous T-cell lymphoma (CTCL): Current practices in blood assessment and the utility of T-cell receptor (TCR)-Vβ chain restriction. Journal Of The American Academy Of Dermatology 2016, 74: 870-877. PMID: 26874819, PMCID: PMC4835257, DOI: 10.1016/j.jaad.2015.12.018.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCross-Sectional StudiesFemaleFlow CytometryHematologic TestsHumansInternationalityLymphoma, T-Cell, CutaneousMaleMiddle AgedMycosis FungoidesNeoplasm InvasivenessNeoplasm StagingPolymerase Chain ReactionPractice Guidelines as TopicPredictive Value of TestsPrognosisRare DiseasesReceptors, Antigen, T-CellRetrospective StudiesSezary SyndromeSkin NeoplasmsSocieties, MedicalConceptsCutaneous T-cell lymphomaT-cell lymphomaCurrent clinical practiceClinical practicePredictive valueNegative predictive valuePositive predictive valueCurrent International SocietyT cell receptorImmunophenotypic abnormalitiesEvidence of clonalitySingle centerTumor burdenBlood assessmentClinical benefitPeripheral bloodCohort casesDisease burdenPolymerase chain reactionStaging criteriaChain restrictionRetrospective analysisMalignant cellsFlow cytometryDiagnostic algorithm
2015
Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sézary Syndrome: Effect of Specific Prognostic Markers on Survival and Development of a Prognostic Model
Scarisbrick JJ, Prince HM, Vermeer MH, Quaglino P, Horwitz S, Porcu P, Stadler R, Wood GS, Beylot-Barry M, Pham-Ledard A, Foss F, Girardi M, Bagot M, Michel L, Battistella M, Guitart J, Kuzel TM, Martinez-Escala ME, Estrach T, Papadavid E, Antoniou C, Rigopoulos D, Nikolaou V, Sugaya M, Miyagaki T, Gniadecki R, Sanches JA, Cury-Martins J, Miyashiro D, Servitje O, Muniesa C, Berti E, Onida F, Corti L, Hodak E, Amitay-Laish I, Ortiz-Romero PL, Rodríguez-Peralto JL, Knobler R, Porkert S, Bauer W, Pimpinelli N, Grandi V, Cowan R, Rook A, Kim E, Pileri A, Patrizi A, Pujol RM, Wong H, Tyler K, Stranzenbach R, Querfeld C, Fava P, Maule M, Willemze R, Evison F, Morris S, Twigger R, Talpur R, Kim J, Ognibene G, Li S, Tavallaee M, Hoppe RT, Duvic M, Whittaker SJ, Kim YH. Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sézary Syndrome: Effect of Specific Prognostic Markers on Survival and Development of a Prognostic Model. Journal Of Clinical Oncology 2015, 33: 3766-3773. PMID: 26438120, PMCID: PMC4979132, DOI: 10.1200/jco.2015.61.7142.Peer-Reviewed Original ResearchConceptsMF/Sézary syndromeAdvanced-stage MF/Sézary syndromeMedian overall survivalSézary syndromeIndependent prognostic markerOverall survivalPrognostic markerWorse survivalMycosis fungoidesAdvanced MF/SSSurvival rateAdvanced-stage mycosis fungoidesIdentical T-cell clonesStage IIB diseaseStage III diseaseStage IV diseaseSingle-center trialAdvanced-stage patientsIndependent prognostic valueSerum lactate dehydrogenasePrognostic index modelSpecific prognostic markersLarge cell transformationT cell clonesIIB diseasePhase 1/2 study of mogamulizumab, a defucosylated anti-CCR4 antibody, in previously treated patients with cutaneous T-cell lymphoma
Duvic M, Pinter-Brown LC, Foss FM, Sokol L, Jorgensen JL, Challagundla P, Dwyer KM, Zhang X, Kurman MR, Ballerini R, Liu L, Kim YH. Phase 1/2 study of mogamulizumab, a defucosylated anti-CCR4 antibody, in previously treated patients with cutaneous T-cell lymphoma. Blood 2015, 125: 1883-1889. PMID: 25605368, PMCID: PMC4375715, DOI: 10.1182/blood-2014-09-600924.Peer-Reviewed Original ResearchConceptsCutaneous T-cell lymphomaEfficacy of mogamulizumabT-cell lymphomaAnti-CC chemokine receptor 4 monoclonal antibodyFrequent treatment-emergent adverse eventsCutaneous T-cell lymphoma patientsTreatment-emergent adverse eventsT-cell lymphoma patientsSignificant hematologic effectsInfusion-related reactionsPhase 1/2 studyOverall response ratePhase 3 investigationAnti-CCR4 antibodyEvaluable patientsBlood involvementAdverse eventsGrade 1/2Sézary syndromeComplete responseMycosis fungoidesLymphoma patientsHematologic effectsDisease progressionMogamulizumab
2011
Multicenter Phase II Trial of Temozolomide in Mycosis Fungoides/Sézary Syndrome: Correlation with O6-Methylguanine-DNA Methyltransferase and Mismatch Repair Proteins
Querfeld C, Rosen ST, Guitart J, Rademaker A, Pezen DS, Dolan ME, Baron J, Yarosh DB, Foss F, Kuzel TM. Multicenter Phase II Trial of Temozolomide in Mycosis Fungoides/Sézary Syndrome: Correlation with O6-Methylguanine-DNA Methyltransferase and Mismatch Repair Proteins. Clinical Cancer Research 2011, 17: 5748-5754. PMID: 21747120, PMCID: PMC3725971, DOI: 10.1158/1078-0432.ccr-11-0556.Peer-Reviewed Original ResearchMeSH KeywordsAdaptor Proteins, Signal TransducingAdultAgedAged, 80 and overAntineoplastic Agents, AlkylatingDacarbazineDNA DamageDNA Mismatch RepairFemaleHumansMaleMiddle AgedMutL Protein Homolog 1MutS Homolog 2 ProteinMycosis FungoidesNuclear ProteinsO(6)-Methylguanine-DNA MethyltransferaseSezary SyndromeTemozolomideTreatment OutcomeConceptsMycosis fungoides/Sézary syndromeMulticenter phase II trialPhase II trialMF/SSMethylguanine-DNA methyltransferaseMutL homolog 1II trialSézary syndromeMedian disease-free survivalMismatch repair protein expressionGrade 3 thrombocytopeniaMedian overall survivalDisease-free survivalEfficacy of temozolomideRepair protein expressionProtein expression levelsOral derivativeComplete remissionConstitutional symptomsFrequent toxicitiesGastrointestinal symptomsHematologic toxicityPartial remissionClinical responseOverall survival
2010
Sézary syndrome: Immunopathogenesis, literature review of therapeutic options, and recommendations for therapy by the United States Cutaneous Lymphoma Consortium (USCLC)
Olsen EA, Rook AH, Zic J, Kim Y, Porcu P, Querfeld C, Wood G, Demierre MF, Pittelkow M, Wilson LD, Pinter-Brown L, Advani R, Parker S, Kim EJ, Junkins-Hopkins JM, Foss F, Cacchio P, Duvic M. Sézary syndrome: Immunopathogenesis, literature review of therapeutic options, and recommendations for therapy by the United States Cutaneous Lymphoma Consortium (USCLC). Journal Of The American Academy Of Dermatology 2010, 64: 352-404. PMID: 21145619, DOI: 10.1016/j.jaad.2010.08.037.Peer-Reviewed Original ResearchMeSH KeywordsAlkylating AgentsAntibodies, MonoclonalAntineoplastic AgentsClinical Trials as TopicCombined Modality TherapyDrug Therapy, CombinationEvidence-Based MedicineHistone Deacetylase InhibitorsHumansImmunologic FactorsMethotrexateMycosis FungoidesQuality of LifeRetinoidsSezary SyndromeSkin NeoplasmsConceptsUnited States Cutaneous Lymphoma ConsortiumSézary syndromeTherapeutic optionsTreatment of SSPreventive services guidelinesCurrent treatment optionsEvidence-based medicineMechanism of actionAdjuvant treatmentMycosis fungoidesPoor prognosisCombination therapyTreatment optionsClinical trialsClinical carePromising treatmentSpecific efficacyStandardized reviewOverall efficacyStandardized criteriaTherapyService guidelinesAdverse effectsImmunopathogenesisTreatment
2008
Cutaneous T-cell Lymphoma
Lansigan F, Choi J, Foss FM. Cutaneous T-cell Lymphoma. Hematology/Oncology Clinics Of North America 2008, 22: 979-996. PMID: 18954747, DOI: 10.1016/j.hoc.2008.07.014.Peer-Reviewed Original Research
2007
Mycosis Fungoides: Pathophysiology and Emerging Therapies
Duvic M, Foss FM. Mycosis Fungoides: Pathophysiology and Emerging Therapies. Seminars In Oncology 2007, 34: s21-s28. PMID: 18086343, DOI: 10.1053/j.seminoncol.2007.11.006.Peer-Reviewed Original ResearchConceptsCutaneous T-cell lymphomaMycosis fungoidesRefractory cutaneous T-cell lymphomaPrimary cutaneous T-cell lymphomaNeoplastic T lymphocytesSafe treatment strategyNon-Hodgkin lymphomaT-cell lymphomaLeukemic variant Sézary syndromeHistone deacetylase inhibitorsOrgan complicationsSystemic regimensCutaneous manifestationsEmerging TherapiesSézary syndromeSkin infiltrationSystemic therapyBiologic agentsCTCL subtypesTreatment strategiesCurrent treatmentT lymphocytesDeacetylase inhibitorsPurine nucleoside phosphorylase inhibitorTherapyEfficacy and tolerability of currently available therapies for the mycosis fungoides and Sezary syndrome variants of cutaneous T-cell lymphoma
Whittaker SJ, Foss FM. Efficacy and tolerability of currently available therapies for the mycosis fungoides and Sezary syndrome variants of cutaneous T-cell lymphoma. Cancer Treatment Reviews 2007, 33: 146-160. PMID: 17275192, DOI: 10.1016/j.ctrv.2006.08.006.Peer-Reviewed Original ResearchConceptsCutaneous T-cell lymphomaT-cell lymphomaMycosis fungoidesTherapeutic optionsPrimary cutaneous T-cell lymphomaSkin-directed therapiesAggressive clinical courseCurrent therapeutic optionsNon-Hodgkin lymphomaNovel therapeutic targetCritical unmet needWorld Health OrganizationCharacteristic clinicopathologicImmunologic changesCutaneous lymphomasDurable responsesSystemic therapyClinical courseDefinitive treatmentSezary syndromeImmunophenotypic featuresTreatment of cancerAvailable therapiesCell transplantationDisease progression
2006
Clinical Experience: Practical Management of Five Patients With Cutaneous T-Cell Lymphoma (CTCL)-Related Symptoms
Dummer R, Foss F, Dreno B, Bagot M. Clinical Experience: Practical Management of Five Patients With Cutaneous T-Cell Lymphoma (CTCL)-Related Symptoms. Seminars In Oncology 2006, 33: 26-32. PMID: 16516673, DOI: 10.1053/j.seminoncol.2005.12.020.Peer-Reviewed Original ResearchConceptsCutaneous T-cell lymphomaSkin-directed therapiesEarly-stage diseasePatient-specific factorsT-cell lymphomaReferral centerStage diseaseSystemic therapyTopical chemotherapyTreatment algorithmTherapeutic optionsIndividual patientsLymphoma managementPatientsSpecialized therapiesTherapyBeam radiationChemotherapySymptomsPractical managementUVA irradiationSpecific factorsPhotopheresisLymphomaCarmustine
2004
Mycosis fungoides and the Sézary syndrome
Foss F. Mycosis fungoides and the Sézary syndrome. Current Opinion In Oncology 2004, 16: 421-428. PMID: 15314509, DOI: 10.1097/00001622-200409000-00002.Peer-Reviewed Original ResearchConceptsEarly-stage patientsSézary syndromeMycosis fungoidesTreatment paradigmPeptide-loaded dendritic cellsEvolution of immunotherapyUse of photopheresisClinical prognostic factorsNucleoside analogue therapyReceptor-directed therapyT cell responsesTreatment of patientsNon-Hodgkin lymphomaNovel treatment optionsFurther clinical evaluationNovel therapeutic approachesHistone deacetylase inhibitorsWorld Health OrganizationAnalogue therapySystemic therapyClinical stagingDendritic cellsPrognostic factorsSézary cellsClinical entity