Updates in cutaneous lymphoma: evidence‐based guidelines for the management of cutaneous lymphoma 2018

Wang, Yanru; Bagot, Martine

doi:10.1111/bjd.17523

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…[3][4][5]13 International treatment guidelines do not recommend any particular order of treatment, and there is a lack of specific data to confirm the appropriateness of current guidelines. [14][15][16][17][18][19] Furthermore, cross-study comparisons have been difficult because of the lack of well-established response criteria, which have only been developed relatively recently. 20 The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) database opened in January 2015 to collect data prospectively on international patients with MF and to investigate the disease course and its prognostic factors.…”

Section: What Does This Study Add?mentioning

confidence: 99%

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Treatment of early‐stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study*

et al. 2021

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Summary Background The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. Here we examine front‐line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF). Objectives To identify (i) differences in first‐line approaches according to tumour‐nodes‐metastasis‐blood (TNMB) staging; (ii) parameters related to a first‐line systemic approach and (iii) response rates and QoL measures. Methods In total, 395 newly diagnosed patients with early‐stage MF (stage IA–IIA) were recruited from 41 centres in 17 countries between 1 January 2015 and 31 December 2018 following central clinicopathological review. Results The most common first‐line therapy was skin‐directed therapy (SDT) (322 cases, 81·5%), while a smaller percentage (44 cases, 11·1%) received systemic therapy. Expectant observation was used in 7·3%. In univariate analysis, the use of systemic therapy was significantly associated with higher clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA–IB vs. IIA, P < 0·001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0·001), higher modified Severity Weighted Assessment Tool (> 10, 15%; ≤ 10, 7%; P = 0·01) and folliculotropic MF (FMF) (24% vs. 12%, P = 0·001). Multivariate analysis demonstrated significant associations with the presence of plaques (T1b/T2b vs. T1a/T2a, odds ratio 3·07) and FMF (odds ratio 2·83). The overall response rate (ORR) to first‐line SDT was 73%, while the ORR to first‐line systemic treatments was lower (57%) (P = 0·027). Health‐related QoL improved significantly both in patients with responsive disease and in those with stable disease. Conclusions Disease characteristics such as presence of plaques and FMF influence physician treatment choices, and SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early‐stage MF need to address these issues.

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Section: What Does This Study Add?mentioning

confidence: 99%

“…International treatment guidelines do not recommend any particular order of treatment, and there is a lack of specific data to confirm the appropriateness of current guidelines 14‐19. Furthermore, cross‐study comparisons have been difficult because of the lack of well‐established response criteria, which have only been developed relatively recently 20…”

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confidence: 99%

Treatment of early‐stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study*

et al. 2021

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“…Traditionally, these patients have been treated with chemotherapy, (i.e., gemcitabine, liposomal doxorubicine, CHOP, and CHOP-like polychemotherapy), but considering the low response and the high toxicity, it should not be taken into account as a primary treatment [15]. To date, allogeneic hematopoietic stem cell transplantation (HSTC), particularly using reduced-intensity conditioning, is the only curative treatment, although intended for only few selected patients [16][17][18]. Overall, SS patients have an unmet clinical need for effective treatments, due to low response rates, short-lived improvements, concomitant immunosuppression, and often severe drug-related side effects [19].…”

Section: Discussionmentioning

confidence: 99%

Sézary Syndrome: Different Erythroderma Morphological Features with Proposal for a Clinical Score System

Roccuzzo

Giordano

Avallone

et al. 2022

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Sézary syndrome is a rare subtype of cutaneous T-cell lymphoma characterized by erythroderma, peripheral lymphadenopathies, and circulating atypical cerebriform T-cells. To date, no definite staging system has been developed for these patients. In this retrospective analysis of the archive of the Dermatological Clinic of the University of Turin, Italy, erythrodermic SS patients were classified according to clinical records and photographs into three main presentations: erythematous, infiltrated, or melanodermic. The pattern of erythroderma was found to be associated with disease outcome, as better survivals were recorded in patients with erythematous and infiltrative erythroderma. Patients in the melanodermic group, though less represented in our investigation, seemed to show a worse trend in survival. According to this preliminary evidence, a new prognostic classification, with a revised score specific for Sézary syndrome patients, can be proposed to usefully integrate the current staging system. The correlation displayed in our research will be hopefully confirmed by prospective studies with larger cohorts, with the aim of identifying significant prognostic features in this subset of cutaneous T-cell lymphoma patients.

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“…Overall survival rates in SS are still low, varying from 7.5 to 22.4 months (27). Allogeneic stem cell transplantation (alloSCT), particularly using reduced-intensity conditioning, remains the only treatment option with curative intention for few selected patients (28). Notably, new options have become available in the last years.…”

Section: Current Therapies For Ctclmentioning

confidence: 99%

Immune Check Point Inhibitors in Primary Cutaneous T-Cell Lymphomas: Biologic Rationale, Clinical Results and Future Perspectives

et al. 2021

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Primary cutaneous T-cell lymphomas (PCTCL) are the most common types of cutaneous lymphomas, with Mycosis fungoides as the most frequent subtype. Besides early stages which usually have a good prognosis, advanced stages remain a great therapeutic challenge with low survival rates. To date, none of the currently available therapeutic options have significantly improved the outcomes of advanced cutaneous lymphomas. Recent studies have demonstrated that immune-checkpoint molecules, such as PD-1 and CTLA-4, play part in the proliferation pathways of neoplastic T-cells, as well as in other tumors. Hence, the potential role of immune-checkpoint-inhibitors in treating cutaneous lymphomas has been investigated in the last years. Herein, we outline the current knowledge regarding the role of immune-checkpoint molecules in PCTCL, their signaling pathways, microenvironment and therapeutic inhibition rationale. Moreover, we review the published data on immunotherapies in PCTCL and summarize the currently ongoing clinical trials in this field.

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Updates in cutaneous lymphoma: evidence‐based guidelines for the management of cutaneous lymphoma 2018

Abstract: Linked Article: Gilson et al. Br J Dermatol 2019; 180:496–526.

Cited by 6 publications

References 11 publications

Treatment of early‐stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study*

Treatment of early‐stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study*

Sézary Syndrome: Different Erythroderma Morphological Features with Proposal for a Clinical Score System

Immune Check Point Inhibitors in Primary Cutaneous T-Cell Lymphomas: Biologic Rationale, Clinical Results and Future Perspectives

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