Cutaneous T-cell lymphoma: 2011 update on diagnosis, risk-stratification, and management

Authors

  • Ryan A. Wilcox

    Corresponding author
    1. Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Cancer Center, Ann Arbor, Michigan
    • Division of Hematology/ Oncology, University of Michigan Cancer Center, 1500 E. Medical Center Drive, Room 7216 CC, Ann Arbor, MI 48109-5948
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  • Conflict of interest: Nothing to report

Abstract

Disease overview: Cutaneous T-cell lymphomas are a heterogenous group of T-cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).

Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.

Risk-adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk-adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin-directed therapies is preferred, as both disease-specific and overall survival for these patients is favorable. In contrast, patients with advanced-stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic-response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single-agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly-selected patients with disease refractory to standard treatments, allogeneic stem-cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley-Liss, Inc.

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