Current management strategies for cutaneous T-cell lymphoma.
Cutaneous T-Cell Lymphoma is a group of lymphomas characterized by a malignant proliferation of skin homing T cells. Prognosis is generally good and treatment is based on the stage of the disease with the goal of inducing remission. Patients with disease limited to the skin in the form of patches and plaques respond best to "skin directed therapy" with topical agents including corticosteroids, nitrogen mustard, carmustine, bexarotene gel, as well as phototherapy with ultraviolet B light, PUVA, or photodynamic therapy. Tazarotene and imiquimod show potential in the treatment of early CTCL. Patients with disease resistant to treatment or with advanced disease require more aggressive therapy in the form of total skin electron beam radiation, biologic response modifiers including interferon alpha, bexarotene, denileukin diftitox, extracorporeal photochemotherapy or combination therapy. The use of chemotherapy is used primarily for palliation. Allogeneic hematopoetic stem cell transplantation may represent a successful treatment for treatment resistant disease.
Knobler
Elizabeth
E
Columbia University College of Physicians and Surgeons, New York, New York, USA. ehk3@columbia.edu
D000287:Administration, Topical; D000970:Antineoplastic Agents / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D016410:Lymphoma, T-Cell, Cutaneous / Q000628:therapy*; D010778:Photochemotherapy; D010789:Phototherapy; D012074:Remission Induction / Q000379:methods*; D012878:Skin Neoplasms / Q000628:therapy*; D014916:Whole-Body Irradiation
D000970:Antineoplastic Agents; D007155:Immunologic Factors