1
|
Stamouli M, Gkirkas K, Karagiannidi A, Iliakis T, Chondropoulos S, Thomopoulos T, Nikolaou V, Pappa V, Papadavid E, Tsirigotis P. Allogeneic Stem Cell Transplantation with a Novel Reduced Intensity Conditioning Regimen for the Treatment of Patients with Primary Cutaneous T-cell Lymphomas. Clin Hematol Int 2021; 3:72-76. [PMID: 34595469 PMCID: PMC8432398 DOI: 10.2991/chi.k.210529.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/21/2021] [Indexed: 11/01/2022] Open
Abstract
The prognosis of patients with mycosis fungoides (MF) and Sezary Syndrome (SS) varies greatly, from near normal life expectancy in patients with early stage, to a median survival of less than 2 years for those diagnosed with advanced stage disease. Initial response to treatment is almost always followed by relapse and, finally, most of patients enter a phase of advanced multi-drug resistant disease with a short life expectancy after multiple lines of treatment. Allogeneic stem cell transplantation (allo-SCT) is usually limited to patients with advanced disease resistant to multiple treatments. Retrospective registry-based studies have shown increased Non-relapse Mortality (NRM) rates in patients with poor performance status, as well as in patients treated with myeloablative conditioning regimens. Another major limitation of allo-SCT is the increased relapse rate which occurs in nearly 50% of the cases, and is probably due to the fact that only heavily pretreated patients with advanced disease are referred for allo-SCT. Due to the paucity of data, the ideal conditioning regimen which will provide the maximum therapeutic benefit without the cost of increased NRM is not currently known. In this article we present our experience with a novel regimen in the treatment of patients with advanced MF/SS.
Collapse
Affiliation(s)
- Maria Stamouli
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Konstantinos Gkirkas
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Aggeliki Karagiannidi
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Theodoros Iliakis
- Hematology Division, 1st Department of Internal Medicine, Propaedeutic, LAIKON General Hospital, National and Kapodistrian University of Athens, Greece
| | - Spiros Chondropoulos
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Thomas Thomopoulos
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Vassiliki Nikolaou
- 1st Department of Dermatology, Syggros Hospital, National and Kapodistrian University of Athens, Greece
| | - Vassiliki Pappa
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Panagiotis Tsirigotis
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, ATTIKON General University Hospital, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
2
|
Stolearenco V, Namini MRJ, Hasselager SS, Gluud M, Buus TB, Willerslev-Olsen A, Ødum N, Krejsgaard T. Cellular Interactions and Inflammation in the Pathogenesis of Cutaneous T-Cell Lymphoma. Front Cell Dev Biol 2020; 8:851. [PMID: 33015047 PMCID: PMC7498821 DOI: 10.3389/fcell.2020.00851] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) comprises a group of lymphoproliferative diseases characterized by the accumulation of malignant T cells in chronically inflamed skin lesions. In early stages, the disease presents as skin patches or plaques covering a limited area of the skin and normally follows an indolent course. However, in a subset of patients the cutaneous lesions develop into tumors and the malignant T cells may spread to the lymphatic system, blood and internal organs with fatal consequences. Despite intensive research, the mechanisms driving disease progression remain incompletely understood. While most studies have focused on cancer cell-intrinsic oncogenesis, such as genetic and epigenetic events driving malignant transformation and disease progression, an increasing body of evidence shows that the interplay between malignant T cells and non-malignant cells plays a crucial role. Here, we outline some of the emerging mechanisms by which tumor, stromal and epidermal interactions may contribute to the progression of CTCL with particular emphasis on the crosstalk between fibroblasts, keratinocytes and malignant T cells.
Collapse
Affiliation(s)
- Veronica Stolearenco
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Martin R J Namini
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Siri S Hasselager
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Maria Gluud
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Terkild B Buus
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Willerslev-Olsen
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Niels Ødum
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Thorbjørn Krejsgaard
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|