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Am J Hematol. 2014 Aug;89(8):837-51. doi: 10.1002/ajh.23756.

Cutaneous T-cell lymphoma: 2014 update on diagnosis, risk-stratification, and management.

Author information

1
Division of Hematology/Oncology, University of Michigan Cancer Center, Ann Arbor, Michigan.

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, and blood) 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 or histone deacetylase inhibitors prior to escalating therapy to include systemic, single-agent chemotherapy. Multiagent chemotherapy (e.g., CHOP) may be employed for those patients with extensive visceral involvement requiring rapid disease control. In highly selected patients, allogeneic stem-cell transplantation may be considered.

PMID:
25042790
DOI:
10.1002/ajh.23756
[Indexed for MEDLINE]
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