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Bátai B, Kiss L, Varga L, Nagy Á, Househam J, Baker AM, László T, Udvari A, Horváth R, Nagy T, Csomor J, Szakonyi J, Schneider T, Graham TA, Alpár D, Fitzgibbon J, Szepesi Á, Bödör C. Profiling of Copy Number Alterations Using Low-Coverage Whole-Genome Sequencing Informs Differential Diagnosis and Prognosis in Primary Cutaneous Follicle Center Lymphoma. Mod Pathol 2024; 37:100465. [PMID: 38460675 PMCID: PMC11092316 DOI: 10.1016/j.modpat.2024.100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Primary cutaneous follicle center lymphoma (PCFCL) has an excellent prognosis using local treatment, whereas nodal follicular lymphoma (nFL), occasionally presenting with cutaneous spread, often requires systemic therapy. Distinction of the 2 diseases based on histopathology alone might be challenging. Copy number alterations (CNAs) have scarcely been explored on a genome-wide scale in PCFCL; however, they might serve as potential biomarkers during differential diagnosis and risk stratification. Low-coverage whole-genome sequencing is a robust, high-throughput method for genome-wide copy number profiling. In this study, we analyzed 28 PCFCL samples from 20 patients and compared the copy number profiles with a cohort of diagnostic samples of 64 nFL patients. Although the copy number profile of PCFCL was similar to that of nFL, PCFCL lacked amplifications of 18q, with the frequency peaking at 18q21.33 in nFL cases involving the BCL2 locus (PCFCL: 5.0% vs nFL: 31.3%, P = .018, Fisher exact test). Development of distant cutaneous spread was significantly associated with higher genomic instability including the proportion of genome altered (0.02 vs 0.13, P = .033) and number of CNAs (2 vs 9 P = .017), as well as the enrichment of 2p22.2-p15 amplification involving REL and XPO1 (6.3% vs 60.0%, P = .005), 3q23-q24 amplification (0.0% vs 50.0%, P = .004), 6q16.1-q23.3 deletion (6.3% vs 50.0%, P = .018), and 9p21.3 deletion covering CDKN2A and CDKN2B loci (0.0% vs 40.0%, P = .014, all Fisher exact test) in PCFCL. Analysis of sequential tumor samples in 2 cases harboring an unfavorable clinical course pointed to the acquisition of 2p amplification in the earliest common progenitor underlining its pivotal role in malignant transformation. By performing genome-wide copy number profiling on the largest patient cohort to date, we identified distinctive CNA alterations conceivably facilitating the differential diagnosis of PCFCL and secondary cutaneous involvement of nFL and potentially aiding the risk stratification of patients with PCFCL in the future.
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Affiliation(s)
- Bence Bátai
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Laura Kiss
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Luca Varga
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Ákos Nagy
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Jacob Househam
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Ann-Marie Baker
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Tamás László
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Anna Udvari
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Róbert Horváth
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Tibor Nagy
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Csomor
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - József Szakonyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Tamás Schneider
- Department of Hematology and Lymphoma, National Institute of Oncology, Budapest, Hungary
| | - Trevor A Graham
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Donát Alpár
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Jude Fitzgibbon
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Ágota Szepesi
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
| | - Csaba Bödör
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
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Martínez-Banaclocha N, Martínez-Madueño F, Caballé B, Badia J, Blanes M, Bujanda DA, Calvo V, Gómez Codina J, Blanco CQ, Espinosa P, Lavernia J, Arroyo FRG, Risueño MG, Llorca C, Cumeras R, Pulla MP, Gumà J. A Descriptive Study of 103 Primary Cutaneous B-Cell Lymphomas: Clinical and Pathological Characteristics and Treatment from the Spanish Lymphoma Oncology Group (GOTEL). Cancers (Basel) 2024; 16:1034. [PMID: 38473391 DOI: 10.3390/cancers16051034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) are B-cell lymphomas that can occur in the skin without evidence of extracutaneous involvement. The 2005 WHO/EORTC classification of cutaneous lymphomas and its 2018 update have distinguished three main categories based on clinicopathological, immunohistochemical, and genetic characteristics: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). PCMZL and PCFCL are clinically indolent, while PCDLBCL-LT is an aggressive lymphoma. Due to its low incidence and lack of prospective studies, it is difficult to establish a standard treatment for each subgroup. The objective of our study was to describe the clinical and pathological characteristics of 103 patients with cutaneous B-cell lymphoma from 12 centres belonging to the Spanish Lymphoma Oncology Group. The median age was 53 years (40-65). According to skin extension, 62% had single-site lymphoma, 17% had regional lymphoma, and 20% had multifocal lymphoma. Histology: 66% had PCMZL, 26% had PCFCL, and 8% had PCDLBCL-LT. Twenty-three percent of the patients were treated exclusively with surgery, 26% with radiotherapy only, 21% with surgery plus radiotherapy, 10% with polychemotherapy, and 5% with rituximab monotherapy. Overall, 96% of patients achieved a complete response, and 44% subsequently relapsed, most of them relapsing either locally or regionally. The 10-year OS was 94.5% for the entire cohort, 98% for the PCMZL cohort, 95% for the PCFCL cohort, and 85.7% for the PCDLBCL-LT cohort. Our data are comparable to those of other published series, except for the high frequency of PCMZL. The expected heterogeneity in therapeutic management has been observed.
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Affiliation(s)
- Natividad Martínez-Banaclocha
- Medical Oncology Department, Hospital General Universitario Dr. Balmis, Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Francisca Martínez-Madueño
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Berta Caballé
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Joan Badia
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Mar Blanes
- Dermatology Department, Hospital General Universitario Dr. Balmis, Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - David Aguiar Bujanda
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrin, 35010 Las Palmas de Gran Canaria, Spain
| | - Virginia Calvo
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain
| | - Jose Gómez Codina
- Medical Oncology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Cristina Quero Blanco
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Pablo Espinosa
- Dermatology Department, Hospital Infanta Cristina, 28981 Parla, Spain
| | - Javier Lavernia
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología (I.V.O.), 46009 Valencia, Spain
| | | | - María Guirado Risueño
- Medical Oncology Department, Hospital General Universitario de Elche, 03203 Alicante, Spain
| | - Cristina Llorca
- Medical Oncology Department, Hospital General Universitario de Elda, 03600 Alicante, Spain
| | - Raquel Cumeras
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Mariano Provencio Pulla
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain
| | - Josep Gumà
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
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3
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Olsen EA, Hodak E, Geskin L, Scarisbrick J. Bridging the specialty gap: Update on primary cutaneous lymphomas. J Am Acad Dermatol 2024; 90:257-260. [PMID: 38043039 DOI: 10.1016/j.jaad.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Elise A Olsen
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina.
| | - Emmilia Hodak
- Rabin Medical Center, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel
| | - Larisa Geskin
- Department of Dermatology, Irving Medical Center, Columbia University, New York, New York
| | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, United Kingdom
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4
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Walewska R, Eyre TA, Barrington S, Brady J, Fields P, Iyengar S, Joshi A, Menne T, Parry-Jones N, Walter H, Wotherspoon A, Linton K. Guideline for the diagnosis and management of marginal zone lymphomas: A British Society of Haematology Guideline. Br J Haematol 2024; 204:86-107. [PMID: 37957111 DOI: 10.1111/bjh.19064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Renata Walewska
- Cancer Care, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Toby A Eyre
- Department of Haematology, Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sally Barrington
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's Health Partners, Kings College London, London, UK
| | - Jessica Brady
- Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul Fields
- Guy's and St Thomas' Hospital, Kings Health Partners, London, UK
| | - Sunil Iyengar
- Department of Haematology, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Anurag Joshi
- All Wales Lymphoma Panel, Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nilima Parry-Jones
- Department of Haematology, Aneurin Bevan University Health Board, Newport, Wales, UK
| | - Harriet Walter
- The Ernest and Helen Scott Haematological Research Institute, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Andrew Wotherspoon
- Department of Histopathology, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Kim Linton
- Division of Cancer Sciences, The Christie NHS Foundation Trust and The University of Manchester, Manchester, UK
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5
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Ninosu N, Melchers S, Kappenstein M, Booken N, Hansen I, Blanchard M, Guenova E, Assaf C, Goerdt S, Nicolay JP. Mogamulizumab Combined with Extracorporeal Photopheresis as a Novel Therapy in Erythrodermic Cutaneous T-cell Lymphoma. Cancers (Basel) 2023; 16:141. [PMID: 38201568 PMCID: PMC10778082 DOI: 10.3390/cancers16010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Primary cutaneous T-cell lymphomas (CTCLs) are rare lymphoproliferative malignancies characterized by significant morbidity and mortality in advanced disease stages. As curative approaches apart from allogeneic stem cell transplantation are lacking, establishing new treatment options, especially combination therapies, is crucial. METHODS This retrospective study included 11 patients with SS or MF receiving therapy with mogamulizumab in combination with ECP from four European expert centers. The response rates in the skin and blood as well as treatment use and adverse events (AE) were described. RESULTS 8/11 patients (73%) showed an overall response (OR) in the skin. The mean mSWAT decreased from 98.2 ± 40.8 to 34.6 ± 23.8. The overall response rate (ORR) in the blood was 64% with two complete responses. During combination therapy, the mean number of Sézary cells decreased from 3365.3 × 106/L before treatment to 1268.6 × 106/L. The mean minimum known period without progress was 7.2 months in the skin and 7.6 months in the blood. The most common AEs were mogamulizumab-associated rash (MAR) (45.5%), anemia (27.3%), lymphocytopenia (27.8%), and infusion related reaction (16.7%). No AE led to treatment discontinuation. CONCLUSIONS Our study presents the combination of mogamulizumab and ECP as an effective therapy in the blood and skin in CTCL with good tolerability, similar to mogamulizumab monotherapy.
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Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany; (N.N.); (S.M.); (S.G.)
| | - Susanne Melchers
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany; (N.N.); (S.M.); (S.G.)
- Skin Cancer Unit, German Cancer Research Center, 69120 Heidelberg, Germany
- Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Max Kappenstein
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany;
| | - Nina Booken
- Department of Dermatology and Venereology, University Skin Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (N.B.); (I.H.)
| | - Inga Hansen
- Department of Dermatology and Venereology, University Skin Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (N.B.); (I.H.)
| | - Maël Blanchard
- Department of Dermatology, Lausanne University Hospital (CHUV) and Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland; (M.B.); (E.G.)
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital (CHUV) and Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland; (M.B.); (E.G.)
| | - Chalid Assaf
- Department of Dermatology, Helios Hospital Krefeld, 47805 Krefeld, Germany;
- Institute for Molecular Medicine, Medical School Hamburg, 20457 Hamburg, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany; (N.N.); (S.M.); (S.G.)
| | - Jan P. Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany; (N.N.); (S.M.); (S.G.)
- Skin Cancer Unit, German Cancer Research Center, 69120 Heidelberg, Germany
- Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
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6
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Hooper MJ, Lee WJ, LeWitt TM, Nguyen C, Griffin T, Chung C, Zhou XA, Guitart J. Epstein-Barr Virus-Associated Lymphomatoid Papules: A Sign of Immunosuppression Resembling Lymphomatoid Papulosis. Am J Dermatopathol 2023; 45:789-800. [PMID: 37982462 PMCID: PMC10662656 DOI: 10.1097/dad.0000000000002479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
ABSTRACT Epstein-Barr virus (EBV)-positive lymphoproliferative disorders associated with immunodeficiency constitute a spectrum of lymphoid and plasma cell proliferations that vary in cytomorphology, immunophenotype, and clinical behavior. CD30-positive cutaneous lymphocytic infiltrates with EBV expression and lymphomatoid papulosis-like presentations have been rarely reported. This retrospective study assessed the clinical and histopathological characteristics of EBV-positive cases with papulonodular morphologies and CD30 positivity seen by Northwestern Medicine Dermatopathology. Twelve patients (7M:5F, mean age 69 years) were presented with papular cutaneous lesions without antecedent patch/plaque disease. Nine cases were associated with known immunosuppression in the setting of transplant-related therapies (n = 4), hematopoietic malignancy (n = 2), post-transplant hematopoietic malignancy (n = 1), and autoimmune disease treatment (n = 2). Two patients had age-related immunosenescence. Four patients demonstrated EBV viremia; for 2 patients, this finding comprised the first sign of immunosuppression. Workup was negative for systemic lymphoma in all patients. Various treatment strategies were used, including observation (n = 3), discontinuation/reduction of immunosuppression (n = 3), rituximab (n = 4), and steroids (n = 4). At mean 30-month follow-up, 4 patients (33.3%) were alive, 3 with and 1 without disease. Eight patients (67.6%) had died, 3 after lesional resolution and 5 with recurrent disease. Biopsies revealed mixed lymphoid infiltrates composed of atypical CD30-positive T cells (n = 5) or B cells (n = 7) with variable EBV-encoded small RNA expression. These cases suggest clinicopathologic presentations resembling lymphomatoid papulosis with atypical, large CD30-positive, EBV-positive cells could comprise first sign of potentially serious immunodeficiency and should prompt evaluation for EBV viremia. These cases also broaden the current picture of immunodeficiency-associated lymphoproliferative disorders to include lymphomatoid papulosis-like clinical presentations.
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Affiliation(s)
- Madeline J Hooper
- Resident Physician, Department of Dermatology, Northwestern University, Chicago, IL
| | - Woo Jin Lee
- Assistant Professor, Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tessa M LeWitt
- Resident Physician, Department of Dermatology, Northwestern University, Chicago, IL
| | - Cuong Nguyen
- Assistant Professor, Department of Dermatology, Northwestern University, Chicago, IL
| | - Teresa Griffin
- Visiting Predoctoral Research Fellow, Department of Dermatology, Northwestern University, Chicago, IL; and
| | - Christopher Chung
- Resident Physician, Department of Dermatology, Northwestern University, Chicago, IL
| | - Xiaolong A Zhou
- Assistant Professor, Department of Dermatology, Northwestern University, Chicago, IL
| | - Joan Guitart
- Professor, Department of Dermatology, Northwestern University, Chicago, IL
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7
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D’Onghia M, Cartocci A, Calabrese L, Maio D, Sirchio A, Erasti M, Tognetti L, Rubegni P, Bocchia M, Cencini E, Fabbri A, Cinotti E. Characteristics of Primary Cutaneous Lymphoma in Italy: A Tertiary Care, Single-Center Study. Curr Oncol 2023; 30:9813-9823. [PMID: 37999132 PMCID: PMC10670225 DOI: 10.3390/curroncol30110712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
Data on primary cutaneous lymphomas (PCLs) patients in the Italian population are limited, and, despite the existence of several treatment options, the management of those patients remains challenging. Our study aimed to investigate the clinical and therapeutic features of PCL patients in a referral center in Italy. We conducted a retrospective study on 100 consecutive PCL patients between January 2017 and December 2022. The mean (SD) age of our cohort was 70.33 (14.14) years. Cutaneous T-cell lymphomas (CTCLs) represented 65% of all cases; the majority were mycosis fungoides (42%), followed by cases of Sezary syndrome (10%) and primary cutaneous anaplastic large cell lymphoma (4%). Cutaneous B-cell lymphomas (CBCLs) accounted for 35 % of PCLs, with 15 cases of primary cutaneous follicle center lymphoma, 10 cases of primary cutaneous diffuse large B-cell lymphoma leg type, and 9 cases of marginal zone B-cell lymphoma. A higher frequency of pruritus (p = 0.008) and higher peripheral blood levels of beta-2 microglobulin (p ≤ 0.001) and lactate dehydrogenase (p = 0.025) were found in CTCLs compared to those of CBCLs. Considering all therapeutic lines performed, treatments were extremely heterogeneous and skin-directed therapies represented the most frequently used approach. Our study confirms the distribution of PCL subtypes formerly reported in the literature and highlights the utility of real-life data in treatments to improve the current management of PCL patients.
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Affiliation(s)
- Martina D’Onghia
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Alessandra Cartocci
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Laura Calabrese
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Daniele Maio
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Azzurra Sirchio
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Maria Erasti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
| | - Monica Bocchia
- Department of Medical, Surgical and Neurological Sciences, Hematology Section, University of Siena, 53100 Siena, Italy; (M.B.); (E.C.); (A.F.)
| | - Emanuele Cencini
- Department of Medical, Surgical and Neurological Sciences, Hematology Section, University of Siena, 53100 Siena, Italy; (M.B.); (E.C.); (A.F.)
| | - Alberto Fabbri
- Department of Medical, Surgical and Neurological Sciences, Hematology Section, University of Siena, 53100 Siena, Italy; (M.B.); (E.C.); (A.F.)
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (A.C.); (L.C.); (D.M.); (A.S.); (M.E.); (L.T.); (P.R.); (E.C.)
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8
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Niu WY, Yan XS, Qiao H, Sun YJ, Gu HY, Li GL, Cui ZG, Du J. An adolescent with primary cutaneous follicle center lymphoma: a case report and literature review. Front Oncol 2023; 13:1273719. [PMID: 38023243 PMCID: PMC10646431 DOI: 10.3389/fonc.2023.1273719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Primary cutaneous follicle center lymphoma (PCFCL) differs from follicular lymphoma in biological behavior and molecular profile and is treated as a distinct entity, according to the 5th edition of the World Health Organization classification of hematolymphoid tumors. It is an uncommon cutaneous B-cell lymphoma that is considerably rare in children and adolescents. To date, only 13 cases of individuals younger than 20 years of age have been reported in the literature. The lack of relevant clinical epidemiological data in this population has hampered the investigation of its clinical and diagnostic aspects. Here we report the case of a 17-year-old male with PCFCL, who may be the first PCFCL patient under 20 years of age reported in China. He was admitted to the hospital with a solitary nodule on his face. After complete surgical excision, the patient's facial mass was histologically identified as PCFCL. The patient's prognosis was favorable, with no recurrence at 17 months of follow-up after the surgical resection. We present a case of an adolescent PCFCL patient and systematically review the literature with a view to increase the awareness of the disease and inform the diagnosis and treatment of this age group.
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Affiliation(s)
- Wen-Yan Niu
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xue-Shen Yan
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Han Qiao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu-Jiao Sun
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hai-Yan Gu
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guang-Lun Li
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhong-Guang Cui
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Juan Du
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
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9
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Miyagaki T, Inoue N, Kamijo H, Boki H, Takahashi-Shishido N, Suga H, Shimauchi T, Kiyohara E, Hirai Y, Yonekura K, Takeuchi K, Sugaya M. Prognostic factors for primary cutaneous anaplastic large-cell lymphoma: a multicentre retrospective study from Japan. Br J Dermatol 2023; 189:612-620. [PMID: 37539944 DOI: 10.1093/bjd/ljad266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND The clinical implications of DUSP22 rearrangement and the association between DUSP22 rearrangement and lymphoid enhancer-binding factor 1 (LEF1) expression pattern in CD30+ cutaneous T-cell lymphomas (CTCLs) are unknown. OBJECTIVES This study assessed the incidence of DUSP22 rearrangement and its clinical and immunohistochemical implications in primary cutaneous anaplastic large-cell lymphoma (pcALCL), lymphomatoid papulosis (LyP) and CD30+ mycosis fungoides with large-cell transformation (MF-LCT), focusing especially on the association with the prognosis and LEF1 expression pattern. Prognostic factors of pcALCL were also examined. METHODS We conducted a multicentre retrospective study including patients with pcALCL, LyP and MF-LCT diagnosed between 1 January 2000 and 31 December 2018 in Japan. Baseline data at diagnosis, treatment course, overall survival (OS) and disease-specific survival (DSS) were collected. Immunohistochemical analysis and fluorescence in situ hybridization to detect DUSP22 and TP63 rearrangement were performed using skin samples at diagnosis. We investigated the association between staining pattern and these gene rearrangements. We also assessed the prognostic implications of clinical status, immunohistochemical results and the presence of gene rearrangements. RESULTS DUSP22 rearrangement was detected in 50% (11 of 22) of cases of pcALCL, but not in any cases with LyP (0 of 14) or MF-LCT (0 of 11). TP63 rearrangement was not detected in any case. Clinically, patients with pcALCL with DUSP22 rearrangement did not tend to develop ulcers (P = 0.081). There was no significant association between DUSP22 rearrangement status and immunohistochemical results, including LEF1 expression pattern. T3 stage and the presence of lower limb lesions were significantly associated with shorter OS (P = 0.012 and 0.021, respectively, by log-rank test). Similarly, they were significantly correlated with shorter DSS (P = 0.016 and 0.0001, respectively). CONCLUSIONS DUSP22 rearrangement is relatively specific to pcALCL among CD30+ CTCLs in Japan. Although the LEF1 expression pattern was not related to DUSP22 rearrangement in pcALCL, there was no rearrangement if LEF1 was not expressed. We confirmed that T3 stage and the lower limb involvement were significantly associated with decreased OS and DSS. The presence or absence of lower limb lesions should be included in T-stage subcategorization in the future.
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Affiliation(s)
- Tomomitsu Miyagaki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
- Department of Dermatology, St Marianna University School of Medicine, Kanagawa, Japan
| | - Norihito Inoue
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroaki Kamijo
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hikari Boki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | | | - Hiraku Suga
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eiji Kiyohara
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoji Hirai
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama,Japan
| | - Kentaro Yonekura
- Department of Dermatology, Imamura General Hospital, Kagoshima, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Chiba, Japan
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Saleh JS, Subtil A, Hristov AC. Primary cutaneous T-cell lymphoma: a review of the most common entities with focus on recent updates. Hum Pathol 2023; 140:75-100. [PMID: 37802757 DOI: 10.1016/j.humpath.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 10/08/2023]
Abstract
Cutaneous T-cell lymphomas are an heterogeneous group of uncommon lymphoid neoplasms that are challenging to diagnose and require close collaboration between dermatologists, pathologists and hematologists/oncologists. This article reviews the most common cutaneous T-cell lymphomas: mycosis fungoides (both classic and variant forms) as well as its leukemic counterpart Sézary syndrome, CD30+ T-cell lymphoproliferative disorders including the ever-expanding group of lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and primary cutaneous CD4+ small/medium lymphoproliferative disorder. We discuss the classic clinical and histopathologic features of these lymphomas and review how they can be distinguished from reactive entities. In particularly, updates to these diagnostic categories and current controversies in classification are highlighted. Moreover, we review the prognosis and treatment for each entity. These lymphomas exhibit variable prognosis, and therefore it is important to correctly classify atypical cutaneous T-cell infiltrates for appropriate patient treatment and prognosis. Cutaneous T-cell lymphomas are at the interface of several medical specialties; this review seeks to summarize key features of these lymphomas and highlight new and emerging insights into these lymphomas.
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Affiliation(s)
- Jasmine S Saleh
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antonio Subtil
- Department of Pathology, Royal Jubilee Hospital, University of British Columbia, Victoria, British Columbia, V8R1J8, Canada
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA.
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11
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Datta D, Pandey RR, Kumar R, Sharma R, Vedant D. F-18 FDG PET/CT in staging and response assessment of primary cutaneous diffuse large B-cell lymphoma (leg type). Eur J Hybrid Imaging 2023; 7:15. [PMID: 37605015 PMCID: PMC10442286 DOI: 10.1186/s41824-023-00174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
Primary cutaneous Diffuse Large B-Cell Lymphoma-leg type (PCDLBCL-LT) is a rare subtype of cutaneous lymphomas, with high frequency of extra-cutaneous relapse and poor prognosis. We report a case of 70-year-old lady who was diagnosed with PCDLBCL-LT on biopsy and underwent a baseline F-18 FDG PET/CT, followed by interim and post-treatment PET/CTs. With this case report, we highlight the findings of F-18 FDG PET/CT in the staging of this cutaneous lymphoma, and also emphasize on its role in the response assessment.
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Affiliation(s)
- Deepanksha Datta
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India.
| | - Rashim Sharma
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Deepak Vedant
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Saleh JS, Subtil A, Hristov AC. Primary cutaneous T-cell lymphoma: a review of the most common entities with focus on recent updates. Hum Pathol 2023; 138:76-102. [PMID: 37307932 DOI: 10.1016/j.humpath.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
Cutaneous T-cell lymphomas are an heterogeneous group of uncommon lymphoid neoplasms that are challenging to diagnose and require close collaboration between dermatologists, pathologists and hematologists/oncologists. This article reviews the most common cutaneous T-cell lymphomas: mycosis fungoides (both classic and variant forms) as well as its leukemic counterpart Sézary syndrome, CD30+ T-cell lymphoproliferative disorders including the ever-expanding group of lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and primary cutaneous CD4+ small/medium lymphoproliferative disorder. We discuss the classic clinical and histopathologic features of these lymphomas and review how they can be distinguished from reactive entities. In particularly, updates to these diagnostic categories and current controversies in classification are highlighted. Moreover, we review the prognosis and treatment for each entity. These lymphomas exhibit variable prognosis, and therefore it is important to correctly classify atypical cutaneous T-cell infiltrates for appropriate patient treatment and prognosis. Cutaneous T-cell lymphomas are at the interface of several medical specialties; this review seeks to summarize key features of these lymphomas and highlight new and emerging insights into these lymphomas.
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Affiliation(s)
- Jasmine S Saleh
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antonio Subtil
- Department of Pathology, Royal Jubilee Hospital, University of British Columbia, Victoria, British Columbia, V8R1J8, Canada
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA.
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13
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Hristov AC, Tejasvi T, Wilcox RA. Cutaneous B-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management. Am J Hematol 2023; 98:1326-1332. [PMID: 37434388 DOI: 10.1002/ajh.26968] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 07/13/2023]
Abstract
DISEASE OVERVIEW Approximately one-fourth of primary cutaneous lymphomas are B-cell derived and are generally classified into three distinct subgroups: primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone lymphoma (PCMZL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT). DIAGNOSIS Diagnosis and disease classification is based on histopathologic review and immunohistochemical staining of an appropriate skin biopsy. Pathologic review and an appropriate staging evaluation are necessary to distinguish primary cutaneous B-cell lymphomas from systemic B-cell lymphomas with secondary skin involvement. RISK-STRATIFICATION Disease histopathology remains the most important prognostic determinant in primary cutaneous B-cell lymphomas. Both PCFCL and PCMZL are indolent lymphomas that infrequently disseminate to extracutaneous sites and are associated with 5-year survival rates that exceed 95%. In contrast, PCDLBCL, LT is an aggressive lymphoma with an inferior prognosis. RISK-ADAPTED THERAPY PCFCL and PCMZL patients with solitary or relatively few skin lesions may be effectively managed with local radiation therapy. While single-agent rituximab may be employed for patients with more widespread skin involvement, multiagent chemotherapy is rarely appropriate. In contrast, management of patients with PCDLBCL, LT is comparable to the management of patients with systemic DLBCL.
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Affiliation(s)
- Alexandra C Hristov
- Departments of Pathology and Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryan A Wilcox
- Division of Hematology/Oncology, University of Michigan Cancer Center, Ann Arbor, Michigan, USA
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Ribereau-Gayon E, Donzel M, Pham F, Romain-Scelle N, Perier-Muzet M, Balme B, Traverse-Glehen A, Ghesquières H, Dalle S. Brentuximab-vedotin in combination with cyclophosphamide, doxorubicin, prednisolone for the treatment of aggressive CD30-positive cutaneous T-cell lymphomas. Leuk Lymphoma 2023; 64:1424-1432. [PMID: 37255021 DOI: 10.1080/10428194.2023.2216820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
Aggressive CD30-positive cutaneous T-cell lymphomas (CD30+CTCL) are associated with unfavorable prognosis. Anthracycline-based polychemotherapy (CHOP) and brentuximab-vedotin (BV) monotherapy are related to poor outcomes in case of extracutaneous involvement or rapidly-progressing disease. Our objective was to assess the effectiveness of BV + CHP in aggressive CD30+CTCL. We included 7 patients treated with BV + CHP from April 2015 to January 2022: 4 had mycosis fungoides with large-cell transformation, 2 had primary cutaneous anaplastic large-cell lymphoma, and 1 harbored a primary cutaneous aggressive epidermotropic CD8-positive T-cell lymphoma. After a median [IQR] follow-up of 17.2 [13.2-21.0] months, 6/7 patients achieved an ORR lasting ≥4 months. The median [IQR] duration of response was 9.5 [5.9-11.1] months and the median [IQR] progression free survival was 14.9 [11.6-16.4] months. Four patients displayed progression with a median (range) time to next treatment of 15.8 (6.5-16.3) months. Two grade-3 adverse events were reported: febrile neutropenia and thromboembolic event. BV + CHP displayed substantial antitumor activity and favorable safety profile in 7 patients with aggressive CD30+CTCL.
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Affiliation(s)
- Emmanuel Ribereau-Gayon
- Service de Dermatologie, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Donzel
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Pathologie, Pierre Bénite, France
| | - Felix Pham
- Service de Dermatologie, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
| | - Nicolas Romain-Scelle
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Santé Publique, Pierre Bénite, France
| | - Marie Perier-Muzet
- Service de Dermatologie, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
| | - Brigitte Balme
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Pathologie, Pierre Bénite, France
| | | | - Hervé Ghesquières
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service d'Hématologie, Pierre Bénite, France
| | - Stéphane Dalle
- Service de Dermatologie, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
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15
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McDonald EO, Amanullah AA, Park PSU, Song W, Werner TJ, Alavi A, Revheim ME. The role of 18F-FDG PET/CT in primary cutaneous lymphoma: an educational review. Ann Nucl Med 2023; 37:328-348. [PMID: 37095393 DOI: 10.1007/s12149-023-01830-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/05/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Primary cutaneous lymphoma (PCL) is a cutaneous non-Hodgkin's lymphoma that originates in the skin and lacks extracutaneous spread upon initial diagnosis. The clinical management of secondary cutaneous lymphomas is different from that of PCLs, and earlier detection is associated with better prognosis. Accurate staging is necessary to determine the extent of disease and to choose the appropriate treatment. The aim of this review is to investigate the current and potential roles of 18F- fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) in the diagnosis, staging, and monitoring of PCLs. METHODS A focused review of the scientific literature was performed using inclusion criteria to filter results pertaining to human clinical studies performed between 2015 and 2021 that analyzed cutaneous PCL lesions on 18F PET/CT imaging. RESULTS & CONCLUSION A review of 9 clinical studies published after 2015 concluded that 18F-FDG PET/CT is highly sensitive and specific for aggressive PCLs and proved valuable for identifying extracutaneous disease. These studies found 18F-FDG PET/CT highly useful for guiding lymph node biopsy and that imaging results influenced therapeutic decision in many cases. These studies also predominantly concluded that 18F-FDG PET/CT is more sensitive than computed tomography (CT) alone for detection of subcutaneous PCL lesions. Routine revision of nonattenuation-corrected (NAC) PET images may improve the sensitivity of 18F-FDG PET/CT for detection of indolent cutaneous lesions and may expand the potential uses of 18F-FDG PET/CT in the clinic. Furthermore, calculating a global disease score from 18F-FDG PET/CT at every follow-up visit may simplify assessment of disease progression in the early clinical stages, as well as predict the prognosis of disease in patients with PCL.
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Affiliation(s)
| | - Amir A Amanullah
- Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Peter Sang Uk Park
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - William Song
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Thomas J Werner
- Department of Radiology, University of Pennsylvania Hospital, Philadelphia, PA, USA
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania Hospital, Philadelphia, PA, USA
| | - Mona-Elisabeth Revheim
- The Intervention Center, Division of Technology and Innovation, Oslo University Hospital, Oslo, Norway.
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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16
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Atwa HA, Abdelrahman DI. The Value of Immunohistochemical Expression of TOX, ICOS, and GATA-3 in the Diagnosis of Mycosis Fungoides. Appl Immunohistochem Mol Morphol 2023; 31:163-171. [PMID: 36805367 DOI: 10.1097/pai.0000000000001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/22/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Mycosis fungoides (MF) is considered the commonest type of cutaneous T-cell lymphoma representing about 50% of all primary cutaneous lymphomas. Differentiation between MF and another inflammatory dermatitis (BIDs) is important to ensure proper management. AIM We aimed to evaluate the immunohistochemical expression of T OX, ICOS, and GATA binding protein 3 (GATA-3) in early stages MF (stage IA and IB) to establish their diagnostic value and to guide the use of inhibitors in the treatment of cutaneous T-cell lymphomas. MATERIALS AND METHODS A retrospective study of 75 skin paraffin blocks (punch biopsy) 40 cases of MF and 35 cases of eczematous dermatitis as a group representing other inflammatory dermatitis were retrieved from archives of the pathology department of our University, during the period from October 2017 to May 2021. RESULTS About 98% and 90% of patients in the MF group had positive T OX and ICOS, while 70% of them had positive GATA-3. High expression of T OX, ICOS, and GATA-3 was associated with higher stages. CONCLUSIONS T OX is considered a diagnostic marker for early MF. The importance of identifying novel markers in MF expressed by immunohistochemistry, such as ICOS, has been established. According to our results, GATA-3 could be used as an accessory marker in the diagnosis of MF when combined with T OX and ICOS in a panel.
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Affiliation(s)
- Hanaa A Atwa
- Pathology Department, Faculty of Medicine, Zagazig University, Egypt
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17
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. [Translated article] Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T291-T298. [PMID: 36848951 DOI: 10.1016/j.ad.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+ lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, Spain
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, Spain
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Spain
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, Spain
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, Spain
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, Spain
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, Spain
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, Spain
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, Spain
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, Spain
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Burmann SN, Kreuter A, Oellig F, Cerroni L, Michalowitz AL. [Expanding semi-annular plaque and nodules on the back]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:382-385. [PMID: 36725704 DOI: 10.1007/s00105-023-05120-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 02/03/2023]
Affiliation(s)
- Sven-Niklas Burmann
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland.
| | - Frank Oellig
- Pathologie Rhein-Ruhr, Mülheim an der Ruhr, Deutschland
| | - Lorenzo Cerroni
- Dermatohistopathologie, Universitätsklinik für Dermatologie und Venerologie, Graz, Österreich
| | - Alena-Lioba Michalowitz
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland
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19
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Wu YF, Skinner L, Lewis J, Khodadoust MS, Kim YH, Kwong BY, Weng WK, Hoppe RT, Sodji Q, Hui C, Kastelowitz N, Fernandez-Pol S, Hiniker SM. Radiation Therapy for Primary Cutaneous Gamma Delta Lymphoma Prior to Stem Cell Transplantation. Cancer Invest 2023; 41:1-8. [PMID: 33899635 DOI: 10.1080/07357907.2021.1919696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 02/01/2023]
Abstract
We present a patient with widespread PCGD-TCL of the bilateral arms and legs, who underwent radiotherapy with 34 Gy in 17 fractions using circumferential VMAT and 3-D printed bolus to the four extremities prior to planned stem cell transplant, who was then found to have progression in the liver, lung, and skin, followed by drastic regression of all in and out-of-field lesions on imaging 1.5 months later. The cause of regression may be related to a radiation-induced abscopal effect from the immunomodulatory effects of radiation, or related to immune reactivation in the setting of cessation of systemic immunosuppressive agents.
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Affiliation(s)
- Yufan F Wu
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Lawrie Skinner
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jonathan Lewis
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael S Khodadoust
- Internal Medicine, Medical Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Youn H Kim
- Dermatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Bernice Y Kwong
- Dermatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Wen-Kai Weng
- Stem Cell Transplantation, Stanford University School of Medicine, Stanford, CA, USA
| | - Richard T Hoppe
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Quaovi Sodji
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Caressa Hui
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Noah Kastelowitz
- Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Susan M Hiniker
- School of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Hristov AC, Tejasvi T, Wilcox RA. Cutaneous T-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management. Am J Hematol 2023; 98:193-209. [PMID: 36226409 PMCID: PMC9772153 DOI: 10.1002/ajh.26760] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 02/04/2023]
Abstract
DISEASE OVERVIEW Cutaneous T-cell lymphomas are a heterogenous group of T-cell neoplasms 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," 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 the blood involvement are generally approached with systemic therapies, including biologic-response modifiers, histone deacetylase inhibitors, or antibody-based strategies, in an escalating fashion. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
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Affiliation(s)
- Alexandra C. Hristov
- Departments of Pathology and Dermatology, 2800 Plymouth Road, Building 35, Ann Arbor, MI 48109-2800
| | - Trilokraj Tejasvi
- Department of Dermatology, 1910 Taubman Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Ryan A. Wilcox
- Correspondence to: Ryan Wilcox, MD, PhD, Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, 1500 E. Medical Center Drive, Room 4310 CC, Ann Arbor, MI 48109-5948, Phone: (734) 615-9799, Fax: (734) 936-7376,
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21
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Muniesa C, Gallardo F, García-Doval I, Estrach MT, Combalia A, Morillo-Andújar M, De la Cruz-Vicente F, Machan S, Moya-Martínez C, Rovira R, Sanchez-Gonzalez B, Acebo E, Amutio E, Peñate Y, Losada-Castillo MDC, García-Muret MP, Iznardo H, Román-Curto C, Cañueto J, Fernández-de-Misa R, Flórez Á, Izu RM, Torres-Navarro I, Zayas A, Pérez-Paredes G, Blanes M, Yanguas JI, Pérez-Ferriols A, Callejas-Charavia M, Ortiz-Romero PL, Pérez-Gil A, Prieto-Torres L, González-Barca E, Servitje O. Brentuximab vedotin in the treatment of cutaneous T-cell lymphomas: Data from the Spanish Primary Cutaneous Lymphoma Registry. J Eur Acad Dermatol Venereol 2023; 37:57-64. [PMID: 36017748 DOI: 10.1111/jdv.18563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Brentuximab vedotin (BV) has been approved for CD30-expressing cutaneous T-cell lymphoma (CTCL) after at least one previous systemic treatment. However, real clinical practice is still limited. OBJECTIVES To evaluate the response and tolerance of BV in a cohort of patients with CTCL. METHODS We analysed CTCL patients treated with BV from the Spanish Primary Cutaneous Lymphoma Registry (RELCP). RESULTS Sixty-seven patients were included. There were 26 females and the mean age at diagnosis was 59 years. Forty-eight were mycosis fungoides (MF), 7 Sézary syndrome (SS) and 12 CD30+ lymphoproliferative disorders (CD30 LPD). Mean follow-up was 18 months. Thirty patients (45%) showed at least 10% of CD30+ cells among the total lymphocytic infiltrate. The median number of BV infusions received was 7. The overall response rate (ORR) was 67% (63% in MF, 71% in SS and 84% in CD30 LPD). Ten of 14 patients with folliculotropic MF (FMF) achieved complete or partial response (ORR 71%). The median time to response was 2.8 months. During follow-up, 36 cases (54%) experienced cutaneous relapse or progression. The median progression free survival (PFS) was 10.3 months. The most frequent adverse event was peripheral neuropathy (PN) (57%), in most patients (85%), grades 1 or 2. CONCLUSIONS These results confirm the efficacy and safety of BV in patients with advanced-stage MF, and CD30 LPD. In addition, patients with FMF and SS also showed a favourable response. Our data suggest that BV retreatment is effective in a proportion of cases.
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Affiliation(s)
- Cristina Muniesa
- Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Dermatology, Hospital de Viladecans, Viladecans, Barcelona, Spain
| | - Fernando Gallardo
- Department of Dermatology, Hospital del Mar, IMAS-IMIM, Barcelona, Spain
| | | | - M Teresa Estrach
- Department of Dermatology, Hospital Clínic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Andrea Combalia
- Department of Dermatology, Hospital Clínic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Fátima De la Cruz-Vicente
- Department of Hematology, Hospital Universitario Vírgen del Rocío. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Salma Machan
- Department of Dermatology, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Roger Rovira
- Department of Dermatology, Hospital del Mar, IMAS-IMIM, Barcelona, Spain
| | | | - Elvira Acebo
- Department of Dermatology, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - Elena Amutio
- Department of Hematology, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - Yeray Peñate
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran, Canaria, Las Palmas, Spain
| | - Maria Del Carmen Losada-Castillo
- Department of Hematology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran, Canaria, Las Palmas, Spain
| | | | - Helena Iznardo
- Department of Dermatology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Javier Cañueto
- Department of Dermatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ricardo Fernández-de-Misa
- Department of Dermatology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Ángeles Flórez
- Department of Dermatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Rosa María Izu
- Department of Dermatology, Hospital de Basurto, Bilbao, Spain
| | | | - Ana Zayas
- Department of Dermatology, Hospital Universitario Dr Peset, Valencia, Spain
| | - Gema Pérez-Paredes
- Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Mar Blanes
- Department of Dermatology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - J Ignacio Yanguas
- Department of Dermatology, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Amparo Pérez-Ferriols
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Pablo Luis Ortiz-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, Institute I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Amalia Pérez-Gil
- Department of Dermatology, Hospital Universitario Vírgen de Valme, Sevilla, Spain
| | - Lucia Prieto-Torres
- Department of Dermatology, Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | - Eva González-Barca
- Department of Hematology, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de LLobregat, Barcelona, Spain
| | - Octavio Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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22
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. ACTAS DERMO-SIFILIOGRAFICAS 2022; 114:291-298. [PMID: 36529273 DOI: 10.1016/j.ad.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, España
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, España
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, España
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, España
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, España
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, España
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, España
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, España
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, España
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, España
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, España
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, España
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, España
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, España
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, España
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, España; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
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23
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Wang L, Rocas D, Dalle S, Sako N, Pelletier L, Martin N, Dupuy A, Tazi N, Balme B, Vergier B, Beylot-Barry M, Carlotti A, Bagot M, Battistella M, Chaby G, Ingen-Housz-Oro S, Gaulard P, Ortonne N. Primary cutaneous peripheral T-cell lymphomas with a T-follicular helper phenotype: an integrative clinical, pathological and molecular case series study. Br J Dermatol 2022; 187:970-980. [PMID: 35895386 PMCID: PMC10087773 DOI: 10.1111/bjd.21791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Primary cutaneous peripheral T-cell lymphomas with a T-follicular helper phenotype (pcTFH-PTCL) are poorly characterized, and often compared to, but not corresponding with, mycosis fungoides (MF), Sézary syndrome, primary cutaneous CD4+ lymphoproliferative disorder, and skin manifestations of angioimmunoblastic T-cell lymphomas (AITL). OBJECTIVES We describe the clinicopathological features of pcTFH-PTCL in this original series of 23 patients, and also characterize these cases molecularly. METHODS Clinical and histopathological data of the selected patients were reviewed. Patient biopsy samples were also analysed by targeted next-generation sequencing. RESULTS All patients (15 men, eight women; median age 66 years) presented with skin lesions, without systemic disease. Most were stage T3b, with nodular (n = 16), papular (n = 6) or plaque (atypical for MF, n = 1) lesions. Three (13%) developed systemic disease and died of lymphoma. Nine (39%) patients received more than one line of chemotherapy. Histologically, the lymphomas were CD4+ T-cell proliferations, usually dense and located in the deep dermis (n = 14, 61%), with the expression of at least two TFH markers (CD10, CXCL13, PD1, ICOS, BCL6), including three markers in 16 cases (70%). They were associated with a variable proportion of B cells. Eight patients were diagnosed with an associated B-cell lymphoproliferative disorder (LPD) on biopsy, including Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (n = 3), EBV+ LPD (n = 1) and monotypic plasma cell LPD (n = 4). Targeted sequencing showed four patients to have a mutated TET2-RHOAG17V association (as frequently seen in AITL) and another a TET2/DNMT3A/PLCG1/SETD2 mutational profile. The latter patient, one with a TET2-RHOA association, and one with no detected mutations, developed systemic disease and died. Five other patients showed isolated mutations in TET2 (n = 1), PLCG1 (n = 2), SETD2 (n = 1) or STAT5B (n = 1). CONCLUSIONS Patients with pcTFH-PTCL have pathological and genetic features that overlap with those of systemic lymphoma of TFH derivation. Clinically, most remained confined to the skin, with only three patients showing systemic spread and death. Whether pcTFH-PTCL should be integrated as a new subgroup of TFH lymphomas in future classifications is still a matter of debate. What is already known about this topic? There is a group of cutaneous lymphomas that express T-follicular helper (TFH) markers that do not appear to correspond to existing World Health Organization diagnostic entities. These include mycosis fungoides, Sézary syndrome, or primary cutaneous CD4+ small/medium-sized T-cell lymphoproliferative disorder or cutaneous extensions of systemic peripheral T-cell lymphomas (PTCL) with TFH phenotype. What does this study add? This is the first large original series of patients with a diagnosis of primary cutaneous PTCL with a TFH phenotype (pcTFH-PTCL) to be molecularly characterized. pcTFH-PTCL may be a standalone group of cutaneous lymphomas with clinicopathological and molecular characteristics that overlap with those of systemic TFH lymphomas, such as angioimmunoblastic T-cell lymphoma, and does not belong to known diagnostic groups of cutaneous lymphoma. This has an impact on the treatment and follow-up of patients; the clinical behaviour needs to be better clarified in further studies to tailor patient management.
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Affiliation(s)
- Luojun Wang
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Delphine Rocas
- Department of Pathology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Stéphane Dalle
- Department of Dermatology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Nouhoum Sako
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Laura Pelletier
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nadine Martin
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Aurélie Dupuy
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nadia Tazi
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France
| | - Brigitte Balme
- Department of Pathology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Béatrice Vergier
- Department of Pathology, CHU de Bordeaux, Haut-Lévêque Hospital, 33600, Pessac, France.,INSERM, U1312, Université de Bordeaux, 33000, Bordeaux, France
| | - Marie Beylot-Barry
- INSERM, U1312, Université de Bordeaux, 33000, Bordeaux, France.,Department of Dermatology, CHU de Bordeaux, Saint-André Hospital, 33000, Bordeaux, France
| | - Agnès Carlotti
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Cochin Hospital, 75014, Paris, France
| | - Martine Bagot
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Saint-Louis Hospital, 75010, Université Paris Cité, Paris, France
| | - Maxime Battistella
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Saint-Louis Hospital, 75010, Université Paris Cité, Paris, France
| | - Guillaume Chaby
- Department of Dermatology, CHU d'Amiens-Picardie, Hôpital Sud, 80054, Amiens, France
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France
| | - Philippe Gaulard
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nicolas Ortonne
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
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Panel Sequencing of Primary Cutaneous B-Cell Lymphoma. Cancers (Basel) 2022; 14:cancers14215274. [DOI: 10.3390/cancers14215274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Primary cutaneous follicular B-cell lymphoma (PCFBCL) represents an indolent subtype of Non-Hodgkin’s lymphomas, being clinically characterized by slowly growing tumors of the skin and common cutaneous relapses, while only exhibiting a low propensity for systemic dissemination or fatal outcome. Up to now, only few studies have investigated underlying molecular alterations of PCFBCL with respect to somatic mutations. Objectives: Our aim was to gain deeper insight into the pathogenesis of PCFBCL and to delineate discriminatory molecular features of this lymphoma subtype. Methods: We performed hybridization-based panel sequencing of 40 lymphoma-associated genes of 10 cases of well-characterized PCFBCL. In addition, we included two further ambiguous cases of atypical B-cell-rich lymphoid infiltrate/B-cell lymphoma of the skin for which definite subtype attribution had not been possible by routine investigations. Results: In 10 out of 12 analyzed cases, we identified genetic alterations within 15 of the selected 40 target genes. The most frequently detected alterations in PCFBCL affected the TNFRSF14, CREBBP, STAT6 and TP53 genes. Our analysis unrevealed novel mutations of the BCL2 gene in PCFBCL. All patients exhibited an indolent clinical course. Both the included arbitrary cases of atypical B-cell-rich cutaneous infiltrates showed somatic mutations within the FAS gene. As these mutations have previously been designated as subtype-specific recurrent alterations in primary cutaneous marginal zone lymphoma (PCMZL), we finally favored the diagnosis of PCMZL in these two cases based on these molecular findings. Conclusions: To conclude, our molecular data support that PCFBCL shows distinct somatic mutations which may aid to differentiate PCFBCL from pseudo-lymphoma as well as from other indolent and aggressive cutaneous B-cell lymphomas. While the detected genetic alterations of PCFBCL did not turn out to harbor any prognostic value in our cohort, our molecular data may add adjunctive discriminatory features for diagnostic purposes on a molecular level.
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Goyal N, O’Leary D, Carter JB, Comfere N, Sokumbi O, Goyal A. A Practical Review of the Presentation, Diagnosis, and Management of Cutaneous B-Cell Lymphomas. Dermatol Clin 2022; 41:187-208. [DOI: 10.1016/j.det.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Treatment of Indolent Cutaneous B-Cell Lymphoma with Intralesional or Intravenous Rituximab. Cancers (Basel) 2022; 14:cancers14194787. [PMID: 36230709 PMCID: PMC9564090 DOI: 10.3390/cancers14194787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Cutaneous B-cell lymphomas (CBCL) are a heterogeneous group of mature B-cells neoplasms that present in the skin without evidence of nodal or systemic involvement. Despite being indolent in nature, they tend to recur in a third of patients after treatment. As repetitive treatments may be necessary for patients with CBCL, there is a need for gentle non-invasive therapy. Rituximab is a medication that targets CD20, a receptor regularly expressed on CBCL, and thereby destroys the cancerous cells. This medication can be given as an infusion into the vein or as an injection directly into the skin tumors. In this study, we found that rituximab injections have a similar efficacy compared to infusions for patients with limited CBCL lesions. Abstract Indolent cutaneous B-cell lymphomas (CBCL) are a rare disease for which the therapeutic recommendations are based on clinical reports. Recommendations for solitary lesions include surgery or irradiation. However, the high relapse rates may require less invasive repeatable therapy. This study seeks to retrospectively assess the efficacy of intralesional rituximab (ILR) for indolent CBCL when compared with intravenous rituximab (IVR). Patients treated for indolent CBCL with ILR or IVR at the Division of DermatoOncology of the University Hospital Heidelberg were eligible for this study. Characteristics of lymphoma, treatment response, and adverse events were assessed. Twenty-one patients, 67% male at a median age of 52 (range 17–80), were included. Nineteen (90%) had only localized lymphoma (stage T1 and T2). Complete response was achieved in 92% (11/12) of ILR after a median of one cycle (three injections) and 78% (7/8) of IVR patients after a median of six cycles. Half of ILR patients and 78% of IVR patients showed relapse after a median of 15 and 23 months, respectively. Adverse reactions were usually mild and were limited to the first injection of ILR. One patient with IVR contracted a pulmonary infection. ILR may be an alternative to the intravenous administration of rituximab for localized indolent CBCL.
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Olsen EA, Whittaker S, Willemze R, Pinter-Brown L, Foss F, Geskin L, Schwartz L, Horwitz S, Guitart J, Zic J, Kim YH, Wood GS, Duvic M, Ai W, Girardi M, Gru A, Guenova E, Hodak E, Hoppe R, Kempf W, Kim E, Lechowicz MJ, Ortiz-Romero P, Papadavid E, Quaglino P, Pittelkow M, Prince HM, Sanches JA, Sugaya M, Vermeer M, Zain J, Knobler R, Stadler R, Bagot M, Scarisbrick J. Primary cutaneous lymphoma: recommendations for clinical trial design and staging update from the ISCL, USCLC, and EORTC. Blood 2022; 140:419-437. [PMID: 34758074 PMCID: PMC9353153 DOI: 10.1182/blood.2021012057] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022] Open
Abstract
The number of patients with primary cutaneous lymphoma (PCL) relative to other non-Hodgkin lymphomas (NHLs) is small and the number of subtypes large. Although clinical trial guidelines have been published for mycosis fungoides/Sézary syndrome, the most common type of PCL, none exist for the other PCLs. In addition, staging of the PCLs has been evolving based on new data on potential prognostic factors, diagnosis, and assessment methods of both skin and extracutaneous disease and a desire to align the latter with the Lugano guidelines for all NHLs. The International Society for Cutaneous Lymphomas (ISCL), the United States Cutaneous LymphomaConsortium (USCLC), and the Cutaneous Lymphoma Task Force of the European Organization for the Research and Treatment of Cancer (EORTC) now propose updated staging and guidelines for the study design, assessment, endpoints, and response criteria in clinical trials for all the PCLs in alignment with that of the Lugano guidelines. These recommendations provide standardized methodology that should facilitate planning and regulatory approval of new treatments for these lymphomas worldwide, encourage cooperative investigator-initiated trials, and help to assess the comparative efficacy of therapeutic agents tested across sites and studies.
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Affiliation(s)
- Elise A Olsen
- Department of Dermatology and Department of Medicine, Division of Hematologic Malignancies, Duke University Medical Center, Durham, NC
| | - Sean Whittaker
- School of Basic and Medical Biosciences, Kings College London and St. Johns Institute of Dermatology, London, United Kingdom
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lauren Pinter-Brown
- Departments of Medicine and Dermatology, Chao Family Comprehensive Cancer Center, University of California-Irvine, Irvine, CA
| | - Francine Foss
- Hematology and Stem Cell Transplantation, Yale University School of Medicine, New Haven, CT
| | - Larisa Geskin
- Department of Dermatology, Columbia University Medical Center, New York, NY
| | - Lawrence Schwartz
- Department of Radiology, Columbia University Medical Center, New York, NY
| | - Steven Horwitz
- Department of Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Joan Guitart
- Departments of Dermatology and Pathology, Northwestern University, Chicago, IL
| | - John Zic
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN
| | - Youn H Kim
- Department of Dermatology, Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA
| | - Gary S Wood
- Department of Dermatology, University of Wisconsin-Madison, Madison, WI
| | - Madeleine Duvic
- University of Texas MD Anderson Cancer Center, Dermatology Unit, Houston, TX
| | - Wei Ai
- Department of Medicine, Division of Hematology and Oncology, University of California, San Francisco, CA
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Alejandro Gru
- Divisions of Dermatopathology and Hematopathology, Department of Pathology, Emily Couric Clinical Cancer Center, University of Virginia, Charlottesville, VA
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel
| | - Richard Hoppe
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - Werner Kempf
- Department of Dermatology, University Hospital Zurich and Kempf and Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | - Ellen Kim
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mary Jo Lechowicz
- Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA
| | - Pablo Ortiz-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, i+12 Institute, CIBERONC, Medical School, Universidad Complutense, Madrid, Spain
| | - Evangelia Papadavid
- Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Athens, Greece
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy
| | - Mark Pittelkow
- Department of Dermatology, Mayo Clinic Arizona, Scottsdale, AZ
| | - H Miles Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Jose Antonio Sanches
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Chiba, Japan
| | - Maarten Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jasmine Zain
- Department of Hematology and Hematopoetic Stem Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Stadler
- University Clinic for Dermatology, Johannes Wesling Medical Centre, University of Bochum, Minden, Germany
| | - Martine Bagot
- Department of Dermatology, Université de Paris, AP-HP, Hôpital Saint-Louis, Paris, France; and
| | - Julia Scarisbrick
- Department of Dermatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Krenitsky A, Klager S, Hatch L, Sarriera-Lazaro C, Chen PL, Seminario-Vidal L. Update in Diagnosis and Management of Primary Cutaneous B-Cell Lymphomas. Am J Clin Dermatol 2022; 23:689-706. [PMID: 35854102 DOI: 10.1007/s40257-022-00704-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
Primary cutaneous lymphomas are a rare group of diseases, with an estimated incidence of 0.5-1 case per 100,000 people per year. Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. There are three main subtypes of pCBCL: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. To date, treatment recommendations for cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. Recently, the pharmacotherapeutic landscape has expanded to include drugs that may modify the underlying disease pathology of pCBCLs, representing new therapeutic modalities for this rare group of diseases. Novel therapies used for other systemic B-cell lymphomas show promise for the treatment of pCBCLs and are being increasingly considered. These new therapies are divided into five main groups: monoclonal antibodies, immune checkpoint inhibitors, small-molecule inhibitors, bispecific T-cell engaging, and chimeric antigen receptor T cell. In this review, we discuss the clinical, histopathological, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management. These emerging treatment strategies for B-cell lymphomas and cutaneous B-cell lymphomas may represent novel first-line options for the management of these rare diseases.
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Affiliation(s)
- Amanda Krenitsky
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA.
| | - Skylar Klager
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
| | - Leigh Hatch
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Pei Ling Chen
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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Barzilai A, Amitay-Laish I, Didkovsky E, Feinmesser M, Dalal A, Schiby G, Hodak E. New Insights into Macular Type of Primary Cutaneous B-Cell Lymphoma: Extension of the Clinical and Histopathological Patterns. Dermatology 2022; 238:1018-1025. [PMID: 35817021 DOI: 10.1159/000525439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary cutaneous B-cell lymphoma (PCBCL) classically presents with papules, plaques, and nodules/tumors. Previous reports of PCBCL manifesting with macular lesions are scarce and focused on primary cutaneous follicle-center cell lymphoma (PCFCL). OBJECTIVES The objective of this study was to report our experience with PCBCL presenting with erythematous macules. METHODS Patients with low-grade PCBCL manifesting with erythematous patches, diagnosed and managed between January 2000 through December 2019 at 2 tertiary cutaneous-lymphoma outpatient clinics, were included. Clinical data were retrospectively collected, and biopsy specimens of the macules, and if present of the typical nodular/tumoral lesions, were reviewed. RESULTS There were 14 patients, aged 16-67 years, 8 had PCFCL and 6 marginal zone lymphoma (PCMZL). All had 1-15 cm erythematous macules, mimicking: interstitial granuloma annulare/vascular tumors/early-stage folliculotropic mycosis fungoides, or presenting with figurate erythema or livedo reticularis-like/net-like pattern. In 3 patients, macules were the presenting lesions, in 2 as the sole manifestation, whereas in 12 patients, typical PCBCL lesions were observed during disease course. The macules showed in all, superficial and deep perivascular infiltrates, and in most, periadnexal infiltrates. Micronodules were observed in 11 specimens, with nodular infiltrates also observed in 4. B cells comprised the majority of the lymphocytes in only 4. Seven of 11 cases tested showed immunoglobulin heavy chain monoclonality. CONCLUSIONS PCMZL and PCFCL may manifest with erythematous macules. Physicians should be aware of this unusual manifestation of low-grade PCBCL, which may represent a clinicopathological diagnostic pitfall.
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Affiliation(s)
- Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel.,Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Amitay-Laish
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, .,Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel,
| | - Elena Didkovsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Meora Feinmesser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Adam Dalal
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Ginette Schiby
- Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
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Jung JM, Lee MY, Won CH, Chang SE, Park CS, Lee MW, Lee WJ. Clinicopathological Factors Associated with the Prognosis and Chronicity of Lymphomatoid Papulosis: A Retrospective Cohort Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:e541-e548. [PMID: 35307318 DOI: 10.1016/j.clml.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The clinical and pathological features of lymphomatoid papulosis (LYP) are diverse. The objective of this study is to evaluate the clinical and pathological features associated with the prognosis and clinical course of LYP. PATIENTS AND METHODS The clinical and pathological features of LYP in a medical center database were retrospectively retrieved. RESULTS Overall, 58 LYP patients were included in the study. The mean age at diagnosis was 39.1 years and the female-to-male ratio was 1:1.2. More than two-thirds (40/58, 69.0%) of the patients showed a chronic and recurrent disease course. A longer pre-diagnosis duration (odds ratio (OR), 1.01; 95% confidence interval (CI), 1.00-1.03) was significantly associated with secondary lymphoma development. Lower extremity involvement (OR, 10.40; 95% CI, 1.17-92.28) and the absence of eosinophils in the lesions (OR, 11.28; 95% CI, 1.01-126.24) were found to be significantly associated with the chronic and recurrent course of LYP. CONCLUSION A longer pre-diagnosis duration is associated with secondary lymphoma, while a lower extremity involvement and the absence of lesional eosinophil infiltration are associated with the chronicity of LYP.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Young Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chan-Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
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Sun Z, Yao X, Ding X, Li X, Tian X. MicroRNAs and their signaling pathway in mycosis fungoides. Medicine (Baltimore) 2022; 101:e29248. [PMID: 35758353 PMCID: PMC9276080 DOI: 10.1097/md.0000000000029248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Oncogenic microRNAs, a kind of stable epigenetic inhibitors, often deregulated in Mycosis fungoides (MF) which affect the skin and tend to transform and spread. RESULTS Previous studies investigating the de-expression of microRNA in MF patients skin biopsies identified that they were not only regulated by signaling pathway, but also regulated other signaling pathway. Furthermore, studies have elucidated the molecular mechanisms of the STAT signaling pathway that can promote a great diversity of miRNA expression via cytokine binding receptors, activating Janus kinase-3 and STAT proteins. But some non-STAT signaling pathway with mircoRNA de-expression in MF was incomplete. CONCLUSION Taken together, these studies demonstrate that microRNA may be used as the prognosis, progression and diagnose of MF, as they can not only control MF cell proliferation, but also induce MF cell apoptosis.
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Kaddu-Mulindwa D, Thurner L, Christofyllakis K, Bewarder M, Kos IA. Management of Extranodal Marginal Zone Lymphoma: Present and Upcoming Perspectives. Cancers (Basel) 2022; 14:cancers14123019. [PMID: 35740684 PMCID: PMC9220961 DOI: 10.3390/cancers14123019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/04/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Extranodal marginal zone lymphoma distinguishes itself from other indolent lymphomas due to its unique pathophysiology and natural history. This is reflected in its management, where next to traditional treatment strategies such as observation, radiotherapy or chemotherapy, eradication of the causal agent and even surgery represent important aspects of therapy. This review focuses on the particular aspects of this indolent lymphoma that affect management and summarizes the current evidence and different guidelines. Abstract Extranodal marginal zone lymphoma (EMZL) encompasses a subgroup of non-Hodgkin lymphomas that often present with localized involvement and may manifest in a diversity of organs and tissues. EMZL pathogenesis is in some cases linked to chronic inflammation/infection, which may impose additional diagnostic and clinical challenges. The most studied and established connection is the presence of Helicobacter pylori in gastric EMZL. Due to its heterogeneity of presentation and intricate pathological features, treatment can be complex, and staging systems are decisive for the choice of therapy. Nevertheless, there is no consensus regarding the most suitable staging system, and recommendations vary among different countries. As a rule of thumb, in limited stages, a local therapy with surgery or radiation is the preferred option, and it is potentially curative. Of note, eradicating the causal agent may be an important step of treatment, especially in gastric EMZL, in which Helicobacter pylori eradication remains the first-line therapy for the majority of patients. In patients with more advanced stages, watch-and-wait is a valuable option, especially amongst those without clear indications for systemic therapy, and it may be carried on for several years. If watch-and-wait is not an option, systemic therapy may be needed. Even though several agents have been tested as monotherapy or in combination in recent years, there is no consensus regarding the first-line therapy, and decisions can vary depending on individual factors, such as age, clinical performance and stage. This review aims to discuss the several aspects of EMZL, including genetic milieu, pathogenesis and staging systems, that may influence the choice of therapy. In addition, we present a summary of evidence of several systemic therapies, compare different recommendations worldwide and discuss future perspectives and novelties in its therapy.
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Albrecht JD, Ninosu N, Barry D, Albrecht T, Schaarschmidt ML, Goerdt S, Nicolay JP. Non-pegylated and Pegylated Interferon Alpha-2a in Cutaneous T-cell Lymphoma and the Risk of Severe Ocular Side-effects. Acta Derm Venereol 2022; 102:adv00722. [PMID: 35506362 PMCID: PMC9593485 DOI: 10.2340/actadv.v102.2487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, DE-68167 Mannheim, Germany.
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, Eich HT, Elsayad K, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Loquai C, Meiss F, Mitteldorf C, Wehkamp U, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stranzenbach R, Moritz R, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k-Leitlinie - Kutane Lymphome (ICD10 C82-C86): Update 2021. J Dtsch Dermatol Ges 2022; 20:537-555. [PMID: 35446484 DOI: 10.1111/ddg.14706_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Helios Klinikum Krefeld
| | | | | | | | - Antonio Cozzio
- Klinik für Dermatologie, Venerologie und Allergologie, Kantonsspital St. Gallen
| | - Hans T Eich
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Münster
| | - Khaled Elsayad
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Münster
| | | | | | - Uwe Hillen
- Klinik für Dermatologie, Universitätsklinikum Essen
| | - Wolfram Klapper
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Claus-Detlev Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe
| | | | - Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinik Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
| | - Christina Mitteldorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Ulrike Wehkamp
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - Jan P Nicolay
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinik Mannheim
| | - Ilske Oschlies
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Max Schlaak
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - René Stranzenbach
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum der Ruhr-Universität Bochum
| | - Rose Moritz
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Halle
| | | | - Tibor Vag
- Nuklearmedizinische Klinik, Klinikum Rechts der Isar, Technische Universität München
| | - Michael Weichenthal
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Rudolf Stadler
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Universitätsklinikum Minden, Universitätsklinikum der Ruhr-Universität Bochum
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, Eich HT, Elsayad K, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Loquai C, Meiss F, Mitteldorf C, Wehkamp U, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stranzenbach R, Moritz R, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k-Guidelines - Cutaneous lymphomas (ICD10 C82 - C86): Update 2021. J Dtsch Dermatol Ges 2022; 20:537-554. [PMID: 35446497 PMCID: PMC9325452 DOI: 10.1111/ddg.14706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Edgar Dippel
- Department of Dermatology, Hospital Ludwigshafen, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Hospital Krefeld, Germany
| | - Jürgen C Becker
- West German Tumor Center, University Hospital Essen, Germany
| | | | | | - Antonio Cozzio
- Department of Dermatology, Venereology and Allergology, Canton Hospital St. Gallen, Switzerland
| | - Hans T Eich
- Department of Radiation Therapy and Radio-Oncology, University Hospital Münster, Germany
| | - Khaled Elsayad
- Department of Radiation Therapy and Radio-Oncology, University Hospital Münster, Germany
| | | | - Stephan Grabbe
- Department of Dermatology, University Hospital Mainz, Germany
| | - Uwe Hillen
- Department of Dermatology, University Hospital Essen, Germany
| | - Wolfram Klapper
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Municipal Hospital of Karlsruhe, Academic Teaching Hospital for the University of Freiburg, Karlsruhe, Germany
| | - Carmen Loquai
- Department of Dermatology, University Hospital Mainz, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, University Hospital Freiburg, medical Faculty, Albert-Ludwigs University Freiburg, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Dorothee Nashan
- Department of Dermatology, Dortmund Hospital GmbH, Dortmund, Germany
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Hospital Mannheim, Germany
| | - Ilske Oschlies
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Max Schlaak
- Charité - Universitätsmedizin Berlin, Department of Dermatology, Venereology and Allergology, Berlin, Germany
| | - René Stranzenbach
- Department of Dermatology, Venereology and Allergology, University Hospital at Ruhr University Bochum, Germany
| | - Rose Moritz
- Department for Dermatology, University Hospital Halle, Germany
| | | | - Tibor Vag
- Department of Nuclear Medicine, Technical University of Munich, Germany
| | - Michael Weichenthal
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Germany
| | - Rudolf Stadler
- Department of Dermatology, Venereology, Allergology, and Phlebology, Johannes Wesling University Hospital Minden, University Hospital at Ruhr University Bochum, Germany
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Avallone G, Roccuzzo G, Torres-Navarro I, Gelato F, Mastorino L, Agostini A, Merli M, Cavallo F, Rubatto M, Senetta R, Botella Estrada R, Ribero S, Quaglino P. Association between Primary Cutaneous B-cell Lymphomas and Other Skin Cancers: A Multicentre Cohort Study. Acta Derm Venereol 2022; 102:adv00687. [DOI: 10.2340/actadv.v102.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communication)
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Franceschi J, Ehret M, Visseaux L, Durlach A, Barbe C, Durot É, Grange F. Survival and Prognostic Factors in Patients with Aggressive Cutaneous T-cell Lymphomas. Acta Derm Venereol 2022; 102:adv00676. [PMID: 35083494 PMCID: PMC9558323 DOI: 10.2340/actadv.v102.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aggressive primary cutaneous T-cell lymphomas include advanced-stage mycosis fungoides (stage ≥ IIB mycosis fungoides), Sézary syndrome, gamma/delta cutaneous lymphoma, nasal type lymphoma, aggressive epidermotropic CD8+ T-cell lymphoma and some cutaneous lymphomas not otherwise specified. To evaluate their long-term prognosis, we conducted a retrospective cohort study of 85 patients diagnosed between 2005 and 2020 with advanced-stage mycosis fungoides (n = 48), Sézary syndrome (n = 28) or aggressive non-mycosis fungoides/Sézary syndrome subtypes (n = 9). The median survival times in these 3 groups were 118.7, 45.7 and 11.2 months, respectively, and the 5-year survival rates were 55.3%, 27.8% and 33.3%, respectively. Multivariate analyses in patients with mycosis fungoides/Sézary syndrome identified age ≥ 70 years, Eastern Cooperative Oncology Group Performance Status ≥ 2, and the high-risk group according to the Cutaneous Lymphoma International Consortium prognostic model, as adverse prognostic factors. Seven patients in this mycosis fungoides/Sézary syndrome group were in complete long-term remission after treatment with bexarotene, including 4 patients living without any treatment for 16–101 months.
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Affiliation(s)
- Joséphine Franceschi
- Department of Dermatology, Reims University Hospital, rue du Général Koenig, FR-51100 Reims, France.
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Okamoto H, Okuma K, Nakayama H, Nakamura S, Iijima K, Chiba T, Takemori M, Fujii K, Mikasa S, Nakaichi T, Aikawa A, Katsuta S, Igaki H. In vivo dosimetry for testicular and scalp shielding in total skin electron therapy using a radiophotoluminescence glass dosimeter. JOURNAL OF RADIATION RESEARCH 2022; 63:51-54. [PMID: 34718685 PMCID: PMC8776692 DOI: 10.1093/jrr/rrab100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/19/2021] [Indexed: 06/13/2023]
Abstract
Mycosis fungoides (MF) is a common, low-grade non-Hodgkin's lymphoma of skin-homing T lymphocytes that can be treated via skin-directed radiotherapy. Our institution has implemented total skin electron therapy (TSET) with a 4.3 m source-to-surface distance (SSD) and 6 MeV electron beams with a beam spoiler. A 35-year-old male undergoing TSET desired to avoid radiotherapy-induced hair loss and temporary infertility; therefore, leakage dose to scalp and testicles was reduced with a special radiation shield composed of stacked lead sheets. The shields for the scalp and scrotal were of 3 mm and 6 mm, respectively. To assess leakage doses, a radiophotoluminescence glass dosimeter (RPLD) was placed at every fraction. The difference dose between the measured and prescribed dose at the calibration point was 2%. The top of the head and scrotal surface exhibited 18 cGy and 10 cGy, respectively. Thus, the dose to the scrotal surface was not beyond the testicular tolerance dose of 20 cGy. Results of semen analysis two months postradiotherapy were normal. There was no hair loss during or after radiation therapy. Therefore, the RPLD is a useful in vivo dosimeter that provides technical information on radiation shielding to allow for completion of TSET without hair loss or temporary infertility.
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Affiliation(s)
| | - Kae Okuma
- Corresponding author; Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Tel: +81(3) 3542-2511; Fax +81 (3)3545-3567
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Dobos G, Miladi M, Michel L, Ram-Wolff C, Battistella M, Bagot M, de Masson A. Recent advances on cutaneous lymphoma epidemiology. Presse Med 2022; 51:104108. [PMID: 35026392 DOI: 10.1016/j.lpm.2022.104108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/26/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Primary cutaneous lymphomas are a group of T- (CTCL) and B-cell (CBCL) malignancies. These diseases have different clinical presentations and prognosis. Our knowledge on their epidemiology is limited. Aim of this review was to summarise recent findings on the incidence of CTCL and CBCL, how they change over time, and to describe possible causes and consequences. We found that although there are important differences in the epidemiology of cutaneous lymphomas in different countries, the relative frequency of certain, especially rare lymphomas remains stable. Several studies described growing incidences of both CTCL and CBCL. The emergence of new diagnostic criteria, a more precise definition of the entities and new biomarkers enable a better classification of cases.
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Affiliation(s)
- G Dobos
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France; Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Germany
| | - M Miladi
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - L Michel
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France
| | - C Ram-Wolff
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - M Battistella
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France; Pathology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - M Bagot
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France.
| | - A de Masson
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France
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CUTANEOUS B-CELL LYMPHOMAS: UPDATE ON DIAGNOSIS, RISK-STRATIFICATION, AND MANAGEMENT. Presse Med 2022; 51:104109. [PMID: 35026390 DOI: 10.1016/j.lpm.2022.104109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/27/2021] [Indexed: 12/18/2022] Open
Abstract
PCBCLs are a group of Non-Hodgkin's B-cell lymphomas originating in and usually confined to the skin, representing approximately one fourth of primary cutaneous lymphomas (PCL). Their current classification system has been the result of the joint World Health Organization (WHO) - European Organization for Research and Treatment of Cancer (EORTC) consensus in 2018. To date, several types of PCBCLs have been described in the scientific literature, with different clinical presentation and prognosis. Primary cutaneous follicle-center lymphoma (PCFCL) and primary cutaneous marginal zone lymphoma (PCMZL) are the most common forms, with a typical indolent course. On the contrary, primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is less common, yet more aggressive, with a reported 5-year overall survival of approximatively 50%. In this review, we outline the PCBCLs defining diagnostic criteria, report the features of the less common subtypes and summarize the noteworthy therapeutical options currently available in this field.
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[Current therapeutic options in Mycosis fungoides and Sézary syndrome]. Hautarzt 2022; 73:75-85. [PMID: 34988613 DOI: 10.1007/s00105-021-04924-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
Driven by the approval of new targeted therapies, significant progress has been made in recent years in the clinical management of cutaneous T‑cell lymphomas. Although there are no curative treatment options for cutaneous T‑cell lymphomas, response rates are often encouraging, in particular when using combination therapies. The decision for the appropriate form of treatment depends on the specific diagnosis, disease stage, and the history of prior therapies. This article provides a comprehensive overview of current treatment options in mycosis fungoides and Sézary syndrome, based on the recently published, revised German S2k guidelines on cutaneous lymphomas (update 2021). In addition, we present promising, yet-to-be-approved therapies that at least in part can be already used off-label in clinical practice today.
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Hristov AC, Tejasvi T, Wilcox RA. Cutaneous T-cell lymphomas: 2021 update on diagnosis, risk-stratification, and management. Am J Hematol 2021; 96:1313-1328. [PMID: 34297414 PMCID: PMC8486344 DOI: 10.1002/ajh.26299] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/08/2022]
Abstract
DISEASE OVERVIEW Cutaneous T-cell lymphomas are a heterogenous group of T-cell neoplasms 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 systemic therapies, including biologic-response modifiers, histone deacetylase inhibitors, or antibody-based strategies, in an escalating fashion. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
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Affiliation(s)
- Alexandra C. Hristov
- Departments of Pathology and Dermatology, North Campus Research Complex, Ann Arbor, Michigan, USA
| | - Trilokraj Tejasvi
- Director Cutaneous Lymphoma program, Department of Dermatology, A. Alfred Taubman Health Care Center, Ann Arbor, Michigan, USA
| | - Ryan A. Wilcox
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
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Olszewska-Szopa M, Sobas M, Laribi K, Bao Perez L, Drozd-Sokołowska J, Subocz E, Joks M, Zduniak K, Gajewska M, de Nalecz AK, Romejko-Jarosińska J, Kumiega B, Waszczuk-Gajda A, Wróbel T, Czyz A. Primary cutaneous indolent B-cell lymphomas - a retrospective multicenter analysis and a review of literature. Acta Oncol 2021; 60:1361-1368. [PMID: 34346830 DOI: 10.1080/0284186x.2021.1956689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Primary cutaneous indolent B-cell lymphomas (PCBCLs) are not well characterized due to their rarity and indolent character.Methods: We retrospectively reviewed the data from 52 patients with primary cutaneous follicular lymphoma (PCFL) (n = 26), marginal zone lymphoma (PCMZL) (n = 25) or undefined PCBCL (n = 1) treated in 10 hematology centers in 1999-2019.Results: Patients characteristics and diagnostic approach: In almost half of the patients, pruritus or pain were present at diagnosis. The lesions were predominantly located on the head and trunk. The disease was present in a form of solitary infiltration or disseminated lesions with a similar frequency.Treatment details and outcomes: Surgery, radiotherapy, rituximab alone or combined with chemotherapy were applied as first-line treatment in 33%, 25%, 21% and 21% of patients, with complete response (CR) achieved by 94%, 83%, 50% and 70% of patients, respectively (p = 0.28). The median duration of response (DoR) was 65 months (95%CI 35-155).Survival: After the median follow-up time of 46 months (range: 3-225), the estimated 5-year overall survival (OS) and progression-free survival (PFS) were 93% and 54%, respectively.Discussion: Clinical presentation was largely consistent with the literature data, however, we observed some differences, including higher predilection to affect upper extremities (25%) and more frequent multifocal appearance in PCFCL (64%) and unifocal in PCMZL (70%).A high proportion of patients with indolent PCBCL achieved CR after the first-line therapy (77%), regardless of treatment mode. We did not find any impact of clinical features on treatment outcomes.Conclusions: All treatment modalities resulted in a high overall response rate. Surgery and/or radiotherapy are the optimal therapeutic options for patients with localized disease. The decision to treat systemically should rather be limited to the generalized form of the disease. High response rate, long duration of remission and excellent long-term survival confirm the truly indolent character of PCFCL and PCMZL.
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Affiliation(s)
- Magdalena Olszewska-Szopa
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Marta Sobas
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Kamel Laribi
- Service d'Hématologie, Centre Hospitalier Le Mans, Le Mans, France
| | - Laura Bao Perez
- Division of Hematology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS – SERGAS), Santiago de Compostela, Spain
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland
| | - Edyta Subocz
- Department of Haematology, Military Institute of Medicine, Warsaw, Poland
| | - Monika Joks
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Zduniak
- Department of Pathology, Wrocław Medical University, Wrocław, Poland
| | | | | | - Joanna Romejko-Jarosińska
- Cytogenetic Department, Centre of Oncology, M. Skłodowska-Curie Memorial Institute, Warszawa, Poland
| | - Beata Kumiega
- Department of Hematology, Specialist District Hospital, Nowy Sacz, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland
| | - Tomasz Wróbel
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Anna Czyz
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
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Abstract
Primary cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphomas that present in the skin with no evidence of extracutaneous disease at the time of diagnosis. CTCL subtypes demonstrate a variety of clinical, histological, and molecular features, and can follow an indolent or a very aggressive course. The underlying pathogenetic mechanisms are not yet entirely understood. The pathophysiology of CTCL is complex and a single initiating factor has not yet been identified. Diagnosis is based on clinicopathological correlation and requires an interdisciplinary team. Treatment decision is made based on short-term and long-term goals. Therapy options comprise skin-directed therapies, such as topical steroids or phototherapy, and systemic therapies, such as monoclonal antibodies or chemotherapy. So far, the only curative treatment approach is allogeneic haematopoietic stem cell transplantation. Novel therapies, such as chimeric antigen receptor T cells, monoclonal antibodies or small molecules, are being investigated in clinical trials. Patients with CTCL have reduced quality of life and a lack of effective treatment options. Further research is needed to better identify the underlying mechanisms of CTCL development and course as well as to better tailor treatment strategies to individual patients.
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Miyagaki T. Diagnosis and prognostic stratification of cutaneous lymphoma. J Dermatol 2021; 49:210-222. [PMID: 34346516 DOI: 10.1111/1346-8138.16099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/06/2021] [Accepted: 07/16/2021] [Indexed: 11/27/2022]
Abstract
Primary cutaneous lymphomas are a heterogenous group of non-Hodgkin's lymphoma of both T/natural killer-cell and B-cell origin and defined to primarily present in the skin without extracutaneous involvement at diagnosis. In contrast to nodal non-Hodgkin's lymphoma, cutaneous T-cell lymphomas (CTCL) are more generally seen than cutaneous B-cell lymphomas (CBCL). CTCL and CBCL have various subtypes and each subtype has specifically characteristic clinical, pathological, and prognostic features. The diagnostic methods and staging evaluation of cutaneous lymphomas is mostly common in various guidelines created by professional societies. The diagnosis is made comprehensively based on clinical, pathological, laboratory, radiological, and genetic findings. On the other hand, definite prognostic stratification has not been completely established yet in most cutaneous lymphomas. This article focuses on the general and novel diagnostic methods and the current findings about prognostic factors and stratification in cutaneous lymphomas.
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Affiliation(s)
- Tomomitsu Miyagaki
- Department of Dermatology, St Marianna University School of Medicine, Kawasaki, Japan
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46
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Lee YP, Yoon SE, Song Y, Kim SJ, Yoon DH, Chen TY, Koh YI, Kang KW, Lee HS, Wei KTK, Lim ST, Poon M, Irawan C, Zhao W, Do YR, Lee MH, Ng SC, Lee WS, Guo Y, Zhang H, Kang HJ, Yun HJ, Kim HJ, Lung DTC, Kwak JY, Han JJ, Mun YC, Oh SY, Shim H, Kwon JH, Sohn BS, Park SK, Jo JC, Ko YH, Jun Z, Kim WS. Cutaneous T-cell lymphoma in Asian patients: a multinational, multicenter, prospective registry study in Asia. Int J Hematol 2021; 114:355-362. [PMID: 34302593 DOI: 10.1007/s12185-021-03179-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of T-cell lymphomas with low incidence. Due to their indolent characteristics, treatment strategies have not yet been established for advanced CTCLs. In this study, relative incidence of CTCLs in Asia was estimated and the therapeutic outcomes presented based on various treatments currently used in clinics for advanced CTCLs. As part of a prospective registry study of peripheral T-cell lymphoma (PTCL) conducted across Asia, including Korea, China, Taiwan, Singapore, Malaysia, and Indonesia, subgroup analysis was performed for patients with CTCLs. Among 486 patients with PTCL, 37 with CTCL (7.6%) were identified between April 2016 and February 2019. Primary cutaneous ALK-negative anaplastic large cell lymphoma (ALCL, 35.1%) was the most common subtype. With a median follow-up period of 32.1 months, median progression-free survival (PFS) was 53.5 months (95% CI 0.0-122.5), and overall survival was not reached. 14 patients (48.2%) underwent subsequent treatment after the first relapse, but the response rate was 20% with a PFS of 2.2 months (95% CI 0.3-4.0). Six patients received autologous stem cell transplantation (auto-SCT). However, auto-SCT did not result in better outcomes. Additional studies are needed on standard care treatment of advanced or refractory and relapsed CTCLs.
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Affiliation(s)
- Yong-Pyo Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Sang Eun Yoon
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, 100142, China
| | - Seok Jin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-Gu, Seoul, 06351, Korea
| | - Dok Hyun Yoon
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Tsai-Yun Chen
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - Young Il Koh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, South Korea
| | - Ka Won Kang
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ho Sup Lee
- Division of Hematology-Oncology, Kosin University Gospel Hospital, Busan, South Korea
| | | | | | - Michelle Poon
- Department of Haematology-Oncology, National University Health System, Queenstown, Singapore
| | - Cosphiadi Irawan
- Indonesia Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Indonesia
| | | | - Young Rok Do
- Division of Hematology and Oncology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, South Korea
| | - Mark Hong Lee
- Department of Hematology-Oncology, Konkuk University Medical Center, Seoul, Korea
| | - Soo Chin Ng
- Subang Jaya Medical Center, Kuala Lumpur, Malaysia
| | - Won-Sik Lee
- Division of Hemato-Oncology, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ye Guo
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Huilai Zhang
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hye-Jin Kang
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Hwan Jung Yun
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Hyo Jung Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | | | - Jae-Yong Kwak
- Division of Hematology-Oncology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University, Chonju, South Korea
| | - Jae Joon Han
- Department of Hematology and Medical Oncology, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Yeung-Chul Mun
- Division of Hematology-Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, South Korea
| | - Sung Yong Oh
- Division of Hematology and Oncology, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, South Korea
| | - Hyeok Shim
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, South Korea
| | - Jung Hye Kwon
- Department of Internal Medicine, Division of Hemato-Oncology, Kangdong Sacred Heart Hospital, Hallym University, Seoul, South Korea
| | - Byeong Seok Sohn
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Seong Kyu Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Puchon, South Korea
| | - Jae Cheol Jo
- Division of Hematology and Oncology, Department of Internal Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, South Korea
| | - Young Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Zhu Jun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, 100142, China.
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-Gu, Seoul, 06351, Korea.
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47
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Jiang M, Zhao L, Zheng J, Zhang J, Chen P, Zhou W. Report of Eleven Patients of Subcutaneous Panniculitis-Like T-Cell Lymphoma: Clinicopathologic Features, 18F-FDG PET/CT Findings and Outcome. Front Oncol 2021; 11:650822. [PMID: 34277404 PMCID: PMC8281960 DOI: 10.3389/fonc.2021.650822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/14/2021] [Indexed: 01/02/2023] Open
Abstract
Objectives Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a fairly rare subtype of primary cutaneous lymphoma. This study aims to investigate the clinicopathologic features, 18F-FDG PET/CT findings, and outcome of patients with SPTCL. Methods A retrospective single-center study enrolled 11 patients with SPTCL between August 2010 and March 2020. A total of 26 18F-FDG PET/CT scans were performed, and the initial and follow-up PET/CT imaging features, clinicopathologic and immunohistochemical characteristics, and outcome were analyzed. Results The male-to-female ratio was 1.2. The mean age at diagnosis was 24.2 years (age range: 13-48 years). Histopathological examinations revealed atypical T-lymphocyte rimming of individual subcutaneous adipocytes, mostly with CD2+, CD3+, CD4-, CD5+, CD8+, CD56-, T-cell intracellular antigen-1+, Granzyme B+, and high Ki-67 index. Multiple large skin ulcerations with a maximum diameter of 10 cm were observed in one of the 11 patients (9.1%, 1/11), and hemophagocytic syndrome was found in another one. At initial PET/CT scans, the lesions in all 11 patients showed increased uptake of 18F-FDG with a wide range of maximum standard uptake value (SUVmax) from 2.0 to 14.9. The morphology of the lesions presented as multiple nodules and/or disseminated plaques mainly involving the trunk and/or limbs. Five patients had extracutaneous non-lymph node lesions with SUVmax of 5.6 ± 2.8 on 18F-FDG PET/CT. No significant correlation between SUVmax and Ki-67 index was observed (r = 0.19, P > 0.05). Follow-up 18F-FDG PET/CT scans in six patients showed complete remission of the disease in two, partial remission in three, and progressive disease in one. During the follow-up period, there was no death except for the patient with multiple ulcerations who died 4 months after diagnosis of SPTCL. Conclusions SPTCL may be a group of heterogeneous diseases with varying degrees of 18F-FDG uptake. 18F-FDG PET/CT demonstrates its usefulness in detecting disease extent, providing diagnostic work-up, staging, and evaluating treatment response of SPTCL. Multiple large skin ulcerations may be a factor of poor prognosis for patients with SPTCL.
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Affiliation(s)
- Maoqing Jiang
- Ningbo PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.,Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Long Zhao
- Department of Nuclear Medicine, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jianjun Zheng
- Ningbo PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Jingfeng Zhang
- Ningbo PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Ping Chen
- Department of Nephrology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Wenlan Zhou
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
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48
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Huanosta-Murillo E, Alcántara-Hernández M, Hernández-Rico B, Victoria-Acosta G, Miranda-Cruz P, Domínguez-Gómez MA, Jurado-Santacruz F, Patiño-López G, Pérez-Koldenkova V, Palma-Guzmán A, Licona-Limón P, Fuentes-Pananá EM, Lemini-López A, Bonifaz LC. NLRP3 Regulates IL-4 Expression in TOX + CD4 + T Cells of Cutaneous T Cell Lymphoma to Potentially Promote Disease Progression. Front Immunol 2021; 12:668369. [PMID: 34220814 PMCID: PMC8244903 DOI: 10.3389/fimmu.2021.668369] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2021] [Indexed: 11/27/2022] Open
Abstract
In cutaneous T cell lymphoma (CTCL), a dominant Th2 profile associated with disease progression has been proposed. Moreover, although the production and regulation of IL-4 expression during the early stages of the disease may have important implications in later stages, these processes are poorly understood. Here, we demonstrate the presence of TOX+ CD4+ T cells that produce IL-4+ in early-stage skin lesions of CTCL patients and reveal a complex mechanism by which the NLRP3 receptor promotes a Th2 response by controlling IL-4 production. Unassembled NLRP3 is able to translocate to the nucleus of malignant CD4+ T cells, where it binds to the human il-4 promoter. Accordingly, IL-4 expression is decreased by knocking down and increased by promoting the nuclear localization of NLRP3. We describe a positive feedback loop in which IL-4 inhibits NLRP3 inflammasome assembly, thereby further increasing its production. IL-4 induced a potentially malignant phenotype measured based on TOX expression and proliferation. This mechanism of IL-4 regulation mediated by NLRP3 is amplified in late-stage CTCL associated with disease progression. These results indicate that NLRP3 might be a key regulator of IL-4 expression in TOX+ CD4+ T cells of CTCL patients and that this mechanism might have important implications in the progression of the disease.
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Affiliation(s)
- Enrique Huanosta-Murillo
- Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.,Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Marcela Alcántara-Hernández
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
| | - Brenda Hernández-Rico
- Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.,Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Patricia Miranda-Cruz
- Departamento de Biología Celular, Centro de Investigación y Estudios Avanzados, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Fermín Jurado-Santacruz
- Centro Dermatológico Dr. Ladislao de la Pascua, Secretaría de Salud de la Ciudad de México, Mexico City, Mexico
| | - Genaro Patiño-López
- Laboratorio de Investigación en Inmunología y Proteómica, Sección de Biología Celular de Linfocitos, Unidad de Hemato-Oncología e Investigación Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Vadim Pérez-Koldenkova
- Laboratorio Nacional de Microscopía Avanzada, División de Desarrollo de la Investigación, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Alam Palma-Guzmán
- Laboratorio de Histología, Coordinación de Investigación en Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Paula Licona-Limón
- Departamento de Biología Celular y del Desarrollo, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ezequiel M Fuentes-Pananá
- Unidad de Investigación en Virología y Cáncer, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Alicia Lemini-López
- Servicio de Dermatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Laura C Bonifaz
- Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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49
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Jung JM, Yang HJ, Won CH, Chang SE, Lee MW, Lee WJ. Clinicopathological and prognostic study of primary cutaneous extranodal natural killer/T-cell lymphoma, nasal type: A systematic review. J Dermatol 2021; 48:1499-1510. [PMID: 34060130 DOI: 10.1111/1346-8138.15972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/02/2021] [Accepted: 05/03/2021] [Indexed: 12/29/2022]
Abstract
Comprehensive studies of primary cutaneous extranodal natural killer/T-cell lymphoma (PCENKTL) are scarce. The objectives of this study are to describe PCENKTL in terms of its clinical features, histopathology, immunophenotypes, and prognosis, and to analyze factors affecting patient survival outcomes. We searched four databases and include studies with extractable data. We also searched the Asan Medical Center database for cases of PCENKTL. We include a total of 289 patients. The mean age at diagnosis was 52.8 years and the female to male ratio was 1:1.2. The most common clinical morphology was a subcutaneous nodule, followed by ulceration. About half of the patients presented with disseminated skin lesions. The median overall survival was 12.0 months and the 5-year survival rate was 22.0%. There was no correlation between the clinical morphology or the histopathological features of the skin lesions with the patient outcomes. Advanced TNM stage, a disseminated skin lesion, tumor location on the leg or trunk, the presence of B symptoms, and a high International Prognostic Index score were associated with a worse prognosis, and chemoradiotherapy was associated with a better survival outcome as compared with chemotherapy alone in univariable analyses. In multivariable analyses, only advanced TNM stage and tumor location on the leg were associated with a worse prognosis. In conclusion, PCENKTL is an aggressive cutaneous lymphoma and its prognosis is associated with TNM stage and tumor location.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Joo Yang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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50
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Jonak C, Alkon N, Rindler K, Rojahn TB, Shaw LE, Porkert S, Weninger W, Trautinger F, Stingl G, Tschandl P, Cerroni L, Farlik M, Brunner PM. Single-cell RNA sequencing profiling in a patient with discordant primary cutaneous B-cell and T-cell lymphoma reveals micromilieu-driven immune skewing. Br J Dermatol 2021; 185:1013-1025. [PMID: 34018188 DOI: 10.1111/bjd.20512] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary cutaneous lymphomas comprise a heterogeneous group of B-cell and T-cell malignancies which often show an indolent course, but can progress to aggressive disease in a subset of patients. Diagnosis is often delayed owing to clinical and histopathological similarities with benign inflammatory conditions. Especially during early disease, cancer cells are present at relatively low percentages compared with the inflammatory infiltrate, an interplay that is currently only insufficiently understood. OBJECTIVES To improve diagnostics and perform molecular characterization of a complex type of primary cutaneous lymphoma. METHODS Single-cell RNA sequencing (scRNA-seq) was performed and combined with T-cell and B-cell receptor sequencing. RESULTS We were able to diagnose a patient with concurrent mycosis fungoides (MF) and primary cutaneous follicle centre lymphoma (PCFCL), appearing in mutually exclusive skin lesions. Profiling of tumour cells and the tissue microenvironment revealed a type-2 immune skewing in MF, most likely guided by the expanded clone that also harboured upregulation of numerous pro-oncogenic genes. By contrast, PCFCL lesions exhibited a more type-1 immune phenotype, consistent with its indolent behaviour. CONCLUSIONS These data not only illustrate the diagnostic potential of scRNA-seq, but also allow the characterization of specific clonal populations that shape the unique tissue microenvironment in clinically distinct types of lymphoma skin lesions.
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Affiliation(s)
- C Jonak
- Department of Dermatology, Medical University of Vienna, Austria
| | - N Alkon
- Department of Dermatology, Medical University of Vienna, Austria
| | - K Rindler
- Department of Dermatology, Medical University of Vienna, Austria
| | - T B Rojahn
- Department of Dermatology, Medical University of Vienna, Austria
| | - L E Shaw
- Department of Dermatology, Medical University of Vienna, Austria
| | - S Porkert
- Department of Dermatology, Medical University of Vienna, Austria
| | - W Weninger
- Department of Dermatology, Medical University of Vienna, Austria
| | - F Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.,Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - G Stingl
- Department of Dermatology, Medical University of Vienna, Austria
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Austria
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M Farlik
- Department of Dermatology, Medical University of Vienna, Austria
| | - P M Brunner
- Department of Dermatology, Medical University of Vienna, Austria
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