Cutaneous T-cell lymphoma: 2017 update on diagnosis, risk-stratification, and management

Am J Hematol. 2017 Oct;92(10):1085-1102. doi: 10.1002/ajh.24876.

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: TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a "risk-adapted," multi-disciplinary 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 or histone deacetylase inhibitors prior to escalating therapy to include systemic, single-agent chemotherapy. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.

Publication types

  • Review

MeSH terms

  • Histone Deacetylase Inhibitors / administration & dosage
  • Histone Deacetylase Inhibitors / adverse effects
  • Histone Deacetylase Inhibitors / therapeutic use*
  • Humans
  • Lymphoma, T-Cell, Cutaneous* / diagnosis
  • Lymphoma, T-Cell, Cutaneous* / immunology
  • Lymphoma, T-Cell, Cutaneous* / therapy
  • Mycosis Fungoides / diagnosis
  • Mycosis Fungoides / immunology
  • Mycosis Fungoides / therapy
  • Neoplasm Staging
  • Prognosis
  • Risk Assessment
  • Sezary Syndrome / diagnosis
  • Sezary Syndrome / immunology
  • Sezary Syndrome / therapy
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / immunology
  • Skin Neoplasms* / therapy
  • Stem Cell Transplantation*
  • Survival Analysis

Substances

  • Histone Deacetylase Inhibitors