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Geskin L, Querfeld C, Hodak E, Nikbakht N, Papadavid E, Ardigò M, Wehkamp U, Bagot M. Expert opinions and clinical experiences with chlormethine gel as maintenance treatment for patients with mycosis fungoides. Front Med (Lausanne) 2024; 10:1298988. [PMID: 38304309 PMCID: PMC10832661 DOI: 10.3389/fmed.2023.1298988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/12/2023] [Indexed: 02/03/2024] Open
Abstract
Maintenance treatment can be recommended for patients with mycosis fungoides (MF) whose disease responds to primary treatment. While positive outcomes have been observed in small studies with maintenance therapy, there is a lack of practical guidelines and agreement on when and how maintenance therapy for MF should be approached. In this article, we discuss expert opinions and clinical experiences on the topic of maintenance therapy for patients with MF, with a focus on chlormethine gel. Ideally, patients should have a durable response before initiating maintenance therapy. The definition of and required duration of durable response are topics that are open to debate and currently have no consensus. Chlormethine gel has several attributes that make it suitable for maintenance therapy; it can be easily applied at home, can be combined with other treatment options for maintenance, and has a manageable safety profile. Chlormethine gel as maintenance therapy can be applied at decreasing frequencies after active treatment with chlormethine gel or other therapies until the minimally effective dose is reached. Patients generally tend to adhere well to chlormethine gel maintenance regimens and may remain on treatment for several years. The experiences described here may be useful for clinicians when deciding on maintenance treatment regimens for their patients. Development of guidelines based on clinical trial outcomes will be important to ensure the most effective maintenance treatment strategies are used for patients with MF.
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Affiliation(s)
- Larisa Geskin
- Columbia University Medical Center, Columbia University, New York, NY, United States
| | - Christiane Querfeld
- Division of Dermatology and Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, United States
| | - Emmilia Hodak
- Davidoff Medical Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Evangelia Papadavid
- National Center of Excellence for Rare Disease, Second Department of Dermatology and Venereology, Attikon University General Hospital, Athens, Greece
| | - Marco Ardigò
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
- MSH Medical School Hamburg, Hamburg, Germany
| | - Martine Bagot
- Department of Dermatology, AP-HP, Université de Paris, Hôpital Saint-Louis, Paris, France
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Latzka J, Assaf C, Bagot M, Cozzio A, Dummer R, Guenova E, Gniadecki R, Hodak E, Jonak C, Klemke CD, Knobler R, Morrris S, Nicolay JP, Ortiz-Romero PL, Papadavid E, Pimpinelli N, Quaglino P, Ranki A, Scarisbrick J, Stadler R, Väkevä L, Vermeer MH, Wehkamp U, Whittaker S, Willemze R, Trautinger F. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome - Update 2023. Eur J Cancer 2023; 195:113343. [PMID: 37890355 DOI: 10.1016/j.ejca.2023.113343] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 10/29/2023]
Abstract
On behalf of the EORTC Cutaneous Lymphoma Tumours Group (EORTC-CLTG) and following up on earlier versions published in 2006 and 2017 this document provides an updated standard for the treatment of mycosis fungoides and Sézary syndrome (MF/SS). It considers recent relevant publications and treatment options introduced into clinical practice after 2017. Consensus was established among the authors through a series of consecutive consultations in writing and a round of discussion. Treatment options are assigned to each disease stage and, whenever possible and clinically useful, separated into first- and second line options annotated with levels of evidence. Major changes to the previous version include the incorporation of chlormethine, brentuximab vedotin, and mogamulizumab, recommendations on the use of pegylated interferon α (after withdrawal of recombinant unpegylated interferons), and the addition of paragraphs on supportive therapy and on the care of older patients. Still, skin-directed therapies are the most appropriate option for early-stage MF and most patients have a normal life expectancy but may suffer morbidity and impaired quality of life. In advanced disease treatment options have expanded recently. Most patients receive multiple consecutive therapies with treatments often having a relatively short duration of response. For those patients prognosis is still poor and only for a highly selected subset long term remission can be achieved with allogeneic stem cell transplantation. Understanding of the disease, its epidemiology and clinical course, and its most appropriate management are gradually advancing, and there is well-founded hope that this will lead to further improvements in the care of patients with MF/SS.
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Affiliation(s)
- Johanna Latzka
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, Department of Dermatology and Venereology, University Hospital of St. Pölten, St. Pölten, Austria.
| | - Chalid Assaf
- Department of Dermatology, HELIOS Klinikum Krefeld, Krefeld, Germany; Institute for Molecular Medicine, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany; Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of The Medical School Hamburg, Schwerin, Germany
| | - Martine Bagot
- Department of Dermatology, Hopital Saint Louis, Université Paris Cité, INSERM U976, Paris, France
| | - Antonio Cozzio
- Department of Dermatology and Allergology, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University of Zurich, Zurich, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, University Hospital of Lausanne and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Robert Gniadecki
- Department of Dermatology, University of Copenhagen, Copenhagen, Denmark; Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Emmilia Hodak
- Cutaneous Lymphoma Unit, Davidoff Cancer Center, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Constanze Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stephen Morrris
- Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, UK
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
| | - Pablo L Ortiz-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, Institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Evangelia Papadavid
- National and Kapodistrian University of Athens, 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - Nicola Pimpinelli
- Department of Health Sciences, Division of Dermatology, University of Florence, Florence, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Annamari Ranki
- Department of Dermatology and Allergology, Inflammation Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, UK
| | - Rudolf Stadler
- University Department of Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Centre Minden, Ruhr University Bochum, Bochum, Germany
| | - Liisa Väkevä
- Department of Dermatology and Allergology, Inflammation Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Medical Department, Medical School of Hamburg, Hamburg, Germany
| | - Sean Whittaker
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, Department of Dermatology and Venereology, University Hospital of St. Pölten, St. Pölten, Austria
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Nicolay JP, Melchers S, Albrecht JD, Assaf C, Dippel E, Stadler R, Wehkamp U, Wobser M, Zhao J, Burghaus I, Schneider S, Gülow K, Goerdt S, Schürch CM, Utikal JS, Krammer PH. Dimethyl fumarate treatment in relapsed and refractory cutaneous T-cell lymphoma: a multicenter phase 2 study. Blood 2023; 142:794-805. [PMID: 37217183 PMCID: PMC10644069 DOI: 10.1182/blood.2022018669] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/18/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
Targeted therapies for cutaneous T-cell lymphoma (CTCL) are limited and curative approaches are lacking. Furthermore, relapses and drug induced side effects are major challenges in the therapeutic management of patients with CTCL, creating an urgent need for new and effective therapies. Pathologic constitutive NF-κB activity leads to apoptosis resistance in CTCL cells and, thus, represents a promising therapeutic target in CTCL. In a preclinical study we showed the potential of dimethyl fumarate (DMF) to block NF-κB and, specifically, kill CTCL cells. To translate these findings to applications in a clinical setting, we performed a multicentric phase 2 study evaluating oral DMF therapy in 25 patients with CTCL stages Ib to IV over 24 weeks (EudraCT number 2014-000924-11/NCT number NCT02546440). End points were safety and efficacy. We evaluated skin involvement (using a modified severity weighted assessment tool [mSWAT]), pruritus, quality of life, and blood involvement, if applicable, as well as translational data. Upon skin analysis, 7 of 23 (30.4%) patients showed a response with >50% reduction in the mSWAT score. Patients with high tumor burden in the skin and blood responded best to DMF therapy. Although not generally significant, DMF also improved pruritus in several patients. Response in the blood was mixed, but we confirmed the NF-κB-inhibiting mechanism of DMF in the blood. The overall tolerability of the DMF therapy was very favorable, with mostly mild side effects. In conclusion, our study presents DMF as an effective and excellently tolerable therapeutic option in CTCL to be further evaluated in a phase 3 study or real-life patient care as well as in combination therapies. This trial was registered at www.clinicaltrials.gov as #NCT02546440.
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Affiliation(s)
- Jan P. Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim/ University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany
- Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Susanne Melchers
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim/ University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany
- Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jana D. Albrecht
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim/ University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany
- Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Klinikum Krefeld, Krefeld, Germany
- Institute for Molecular Medicine, Medical School Hamburg, Hamburg, Germany
| | - Edgar Dippel
- Department of Dermatology, Ludwigshafen Medical Center, Ludwigshafen, Germany
| | - Rudolf Stadler
- University Clinic for Dermatology, Johannes Wesling Medical Center, Minden, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Campus Kiel, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Marion Wobser
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Jing Zhao
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Ina Burghaus
- Clinical Study Coordination Center, University of Heidelberg, Heidelberg, Germany
| | - Sven Schneider
- Institute for Clinical Chemistry, University Medical Center Mannheim, Mannheim, Germany
| | - Karsten Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim/ University of Heidelberg, Mannheim, Germany
| | - Christian M. Schürch
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Jochen S. Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim/ University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany
- DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | - Peter H. Krammer
- Department of Immunogenetics D030, German Cancer Research Center, Heidelberg, Germany
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Seidl U, Bohne AS, Kaeding M, Bauer L, Weichenthal M, Wehkamp U, Hutloff A, Schwarz T, Gerdes S, Heine G. Angiolymphoid hyperplasia with eosinophilia infiltrated by GATA3+ Th2 cells responding to dupilumab. J Eur Acad Dermatol Venereol 2023. [PMID: 37060261 DOI: 10.1111/jdv.19116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Affiliation(s)
- U Seidl
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A S Bohne
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Kaeding
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - L Bauer
- Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Weichenthal
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - U Wehkamp
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A Hutloff
- Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - T Schwarz
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - G Heine
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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5
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Jost M, Schwarz T, Wehkamp U, Bohne AS, Drerup K. Rheumatoid neutrophilic dermatosis under treatment with the interleukin-6-receptor-antagonist sarilumab in a patient with seropositive rheumatoid arthritis. J Cutan Pathol 2023. [PMID: 36975158 DOI: 10.1111/cup.14425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 02/24/2023] [Accepted: 03/05/2023] [Indexed: 03/29/2023]
Abstract
Skin manifestations may arise as adverse events following the use of novel drugs. We report a case of a patient with seropositive rheumatoid arthritis who developed a rheumatoid neutrophilic dermatosis (RND) under treatment with the interleukin-6-receptor-antagonist sarilumab. The skin lesions developed 2-3 days after the first injection. RND presents with asymptomatic, symmetrical fixed urticarial-like papules, plaques, and nodules, localized typically on the extensor surfaces of the forearms and hands. After discontinuing the medication, the nodules in our patient disappeared within a month.
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Affiliation(s)
- Marion Jost
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thomas Schwarz
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ann-Sophie Bohne
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Katharina Drerup
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Koch M, Kockmann T, Rodriguez E, Wehkamp U, Hiebert P, Ben-Yehuda Greenwald M, Stölzl D, Beer HD, Tschachler E, Weidinger S, Werner S, Auf dem Keller U. Quantitative Proteomics Identifies Reduced NRF2 Activity and Mitochondrial Dysfunction in Atopic Dermatitis. J Invest Dermatol 2023; 143:220-231.e7. [PMID: 36108803 DOI: 10.1016/j.jid.2022.08.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/04/2022] [Accepted: 08/25/2022] [Indexed: 01/25/2023]
Abstract
Atopic dermatitis is the most common inflammatory skin disease and is characterized by a deficient epidermal barrier and cutaneous inflammation. Genetic studies suggest a key role of keratinocytes in atopic dermatitis pathogenesis, but the alterations in the proteome that occur in the full epidermis have not been defined. Using a pressure-cycling technology and data-independent acquisition approach, we performed quantitative proteomics of epidermis from healthy volunteers and lesional and nonlesional patient skin. Results were validated by targeted proteomics using parallel reaction monitoring mass spectrometry and immunofluorescence staining. Proteins that were differentially abundant in the epidermis of patients with atopic dermatitis versus in healthy control reflect the strong inflammation in lesional skin and the defect in keratinocyte differentiation and epidermal stratification that already characterizes nonlesional skin. Most importantly, they reveal impaired activation of the NRF2-antioxidant pathway and reduced abundance of mitochondrial proteins involved in key metabolic pathways in the affected epidermis. Analysis of primary human keratinocytes with small interfering RNA‒mediated NRF2 knockdown revealed that the impaired NRF2 activation and mitochondrial abnormalities are partially interlinked. These results provide insight into the molecular alterations in the epidermis of patients with atopic dermatitis and identify potential targets for pharmaceutical intervention.
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Affiliation(s)
- Michael Koch
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | - Tobias Kockmann
- Functional Genomics Center Zurich, University of Zurich/ETH Zürich, Zürich, Switzerland
| | - Elke Rodriguez
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Paul Hiebert
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | | | - Dora Stölzl
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hans-Dietmar Beer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Erwin Tschachler
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stephan Weidinger
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sabine Werner
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | - Ulrich Auf dem Keller
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark.
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Oschlies I, Kock K, Wüseke T, Richter J, Koch K, Wehkamp U, Klapper W. Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4 + small or medium T-cell lymphoproliferative disorder. Histopathology 2023; 82:485-494. [PMID: 36341542 DOI: 10.1111/his.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/14/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
AIMS The aim was to gain insight into the biology of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD). METHODS We describe the histopathological and clinical characteristics of 177 PCSM-LPD diagnosed at our consultation centre. We performed immunohistochemical multistaining in a subset of cases (n = 46) including PD1, Cyclin D1, and multiple markers of proliferation. We evaluated clonal T-cell-receptor-(TCR) rearrangements and used tissue microdissection to analyse TCR-clonality of PD1(+) cells. RESULTS The cohort of n = 177 PCSM-LPD included 84 males and 93 females (median age 57, range 13-85). Clinical presentation was as a solitary nodule or plaque (head and neck > trunk > extremities). Most patients were treated by local excision or steroids (96%, 69/72); relapses occurred in 12/65 (18%) of patients with follow up. Histopathology revealed the predominance of a nodular pattern (75%, 134/177) and frequent clustering of PD1(+) large cells (70%, 103/147). We detected Cyclin D1 and PD1 coexpression (>10% of PD1(+)-cells) in 26/46 (57%), which was not associated with CCND1 breaks or amplifications. PD1(+)-cells in PCSM-LPDs showed a significantly higher expression of proliferation-associated proteins compared to PD1(-)-cells. A clonal TCR-rearrangement was present in 176/177 (99%), with a clonal persistence in 7/8 patients at relapse including distant sites. Tissue-microdissection revealed PD1(+)-cells as the source of clonality, whilst PD1(-)-cells remained polyclonal. CONCLUSION PCSM-LPD is a clinically indolent, albeit neoplastic, disease driven by clonal expansion of PD1(+)-cells. We demonstrate Cyclin D1-expression associated with accelerated proliferation as a surprising new biological feature of the disease.
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Affiliation(s)
- Ilske Oschlies
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Katharina Kock
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Thomas Wüseke
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Julia Richter
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Karoline Koch
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
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Najidh S, Van der Sluijs Gelling AJ, Cozzio A, Dobos G, Bagot M, Beylot-Barry M, Guenova E, Nicolay J, Lima M, Ortiz-Romero PL, Papadavid E, Pujol R, Quaglino P, Stadler R, Wehkamp U, Whittaker S, Van Dongen JJM, Montero JF, Almeida J, Vermeer MH. Immunophenotypic identification and characterization of CTCL tumor cells in blood using standardized flow cytometry: a European multicenter study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00548-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Molloy K, Jonak C, Pokert S, Lehner-Baumgartner E, Quaglino P, Borro A, Guenova E, Blanchard G, Fassnacht C, Wehkamp U, Cozzio A, Zeller T, Oerlemans S, Scarisbrick J. Update on the development of EORTC/CLTF questionnaires to assess HRQOL in primary cutaneous T-cell and B-cell lymphomas: phase I. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00587-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Nicolay JP, Albrecht JD, Assaf C, Dippel E, Stadler R, Wehkamp U, Wobser M, Burghaus I, Schneider S, Guelow K, Goerdt S, Krammer PH. Dimethyl fumarate (DMF) therapy in CTCL: final results from a clinical phase II study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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11
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Wehkamp U, Ardigò M, Papadavid E, Querfeld C, Nikbakht N. Chlormethine Gel for Patients with Mycosis Fungoides Cutaneous T Cell Lymphoma: A Review of Efficacy and Safety in Clinical Trial and Real-World Settings. Adv Ther 2022; 39:3979-4002. [PMID: 35852707 PMCID: PMC9294809 DOI: 10.1007/s12325-022-02219-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/08/2022] [Indexed: 01/21/2023]
Abstract
Mycosis fungoides (MF) is a rare disease and is the most common form of cutaneous T cell lymphoma. Topical chlormethine (CL) gel is the first cytotoxic chemotherapy gel that was specifically developed for treatment of MF. In this review, we provide an overview of all available data on the use of CL gel for treatment of patients with MF. On the basis of the current data collected, CL gel is highly effective, with good response rates observed both in clinical trial and real-world settings. While the gel is approved for monotherapy, it is also used in combination with concomitant skin-directed or systemic therapies in clinical practice. Responses to CL gel treatment can be rapid, but they also frequently occur with a delayed onset of up to 6 months. This indicates that continued treatment with CL gel is important. CL gel has a manageable safety profile, with most adverse events being mild and skin related. Contact dermatitis is one of the more common skin-related adverse events to occur with CL gel treatment that can potentially lead to treatment discontinuation. The data from the literature indicate that patients being treated with CL gel should be monitored carefully, and that dermatitis must be managed effectively to allow patients to continue treatment and achieve the best possible response to treatment.
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Affiliation(s)
- Ulrike Wehkamp
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
| | - Marco Ardigò
- San Gallicano Dermatologica Institute IRCCS, Rome, Italy
| | - Evangelia Papadavid
- National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Dermatology and Venereology, National Center of Excellence for Rare Disease, Attikon University General Hospital, Athens, Greece
| | - Christiane Querfeld
- Division of Dermatology, Department of Pathology, City of Hope Comprehensive Cancer Center, Beckman Institute, Duarte, CA USA
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA USA
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12
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Kempf W, Petrella T, Willemze R, Jansen P, Berti E, Santucci M, Geissinger E, Cerroni L, Maubac E, Battistella M, Goodlad J, Guenova E, Lappalainen K, Ranki A, Craig P, Calonje E, Martin B, Whittaker S, Oschlies I, Wehkamp U, Nicolay JP, Wobser M, Scarisbruck J, Pimpinelli N, Stadler R, Kerl K, Quaglino P, Lin J, Chen L, Beer M, Emanuel P, Dalle S, Robson A. Clinical, histopathological and prognostic features of primary cutaneous acral CD8+ T-cell lymphoma and other dermal CD8+ cutaneous lymphoproliferations - Results of an EORTC Cutaneous Lymphoma Group Workshop. Br J Dermatol 2022; 186:887-897. [PMID: 34988968 DOI: 10.1111/bjd.20973] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/27/2021] [Accepted: 12/30/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The differential diagnosis of atypical dermal non-epidermotropic CD8+lymphocytic infiltrates includes a heterogenous spectrum of lymphoproliferations with overlapping histological and phenotypic features, but divergent clinical manifestations and prognoses. As these neoplasms are rare, more data on their clinicopathological presentation and course are needed. OBJECTIVES To assess the clinical, histological, immunophenotypic features, outcome of and differences between dermal CD8+ lymphoproliferations. METHODS Retrospective analysis of a series of 47 patients and biopsies by the international EORTC Cutaneous Lymphoma Group. RESULTS The dermal CD8+ lymphoproliferations (n=46) could be assigned to one of the following 3 groups: (1) cutaneous acral CD8+ T-cell lymphoma (n=31), characterized mostly by a solitary nodule arising at acral sites, a monotonous dermal infiltrate of small to medium-sized CD8+ lymphocytes with a characteristic dot-like pattern of CD68, a low proliferation rate and an excellent prognosis; (2) primary cutaneous CD8+ peripheral T-cell lymphoma, unspecified/NOS (n=11), presenting with one or multiple rapidly evolving tumors, mostly medium-sized pleomorphic CD8+ tumor cells with expression of several cytotoxic markers and high proliferative activity. After chemotherapy or radiotherapy relapses occurred in one third and 1 of 11 patients died due to lymphoma (9%); (3) The third group (n=4) comprised cutaneous CD8+ lymphoproliferations associated with congenital immunodeficiency syndromes in 2 patients with persisting localized or disseminated violaceous to brownish plaques on the extremities, a histiocyte-rich infiltrate of mostly small CD8+ lymphocytes with subtle atypia and a protracted course, and papular CD8+ eruptions in two patients with acquired immunosuppression (HIV-infection, solid organ transplantation). CONCLUSIONS A constellation of distinct clinical, histopathologic and phenotypic features allows discrimination and assignment of dermal CD8+ infiltrates to distinct disease entities including cutaneous acral CD8+ T-cell lymphoma, primary cutaneous CD8+ peripheral T-cell lymphoma, unspecified/NOS and cutaneous CD8+ lymphoproliferations associated with congenital or acquired immunodeficiency syndromes. Primary cutaneous acral CD8+ lymphoma, assigned a provisional category in current lymphoma classifications, is a distinct and reproducible entity. A correct diagnosis is essential to avoid unnecessarily aggressive treatment for indolent CD8+ lymphoproliferations and to identify cases with underlying immunodeficiency or potential for dismal outcome.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Tony Petrella
- Departement of Pathology, Hopital Maisonneuve-Rosemont, Montréal, Canada
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Patty Jansen
- Department of Clinical Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Emilio Berti
- University of Milan, Director U.O.C of Dermatology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Marco Santucci
- Department of Health Sciences, University of Florence School of Human Health Sciences and Division of Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Eva Geissinger
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Austria
| | - Eve Maubac
- Service de Dermatologie du Pr F. Caux, Hôpital Avicenne Bobigny Cedex, France
| | - Maxime Battistella
- Department of Pathology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, INSERM U976, Paris, France
| | | | - Emmanuella Guenova
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Lausanne, Faculty of Biology and Medicine, University of Lausanne, CH-1011, Lausanne, Switzerland
| | | | - Annamari Ranki
- Skin and Allergy Hospital, Helsinki University Central Hospital, Finland
| | - Paul Craig
- Gloucestershire Hospitals NHS Foundation Trust Gloucestershire Cellular Pathology Laboratory, Cheltenham General Hospital, Cheltenham, Gloucestershire, UK
| | - Eduardo Calonje
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, England, UK
| | - Blanca Martin
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, England, UK
| | - Sean Whittaker
- St John's Institute of Dermatology, Guys and St Thomas NHS Foundation Trust, Lomdo, UK
| | - Ilske Oschlies
- Dept. of Pathology, Section Hematopathology and lymph node registry, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Jan P Nicolay
- Dept. of Dermatology, University Medical Center Mannheim, Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergology and Skin Cancer Center, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Julia Scarisbruck
- Department of Dermatology, University Hospital Birmingham, Birmingham, UK
| | - Nicola Pimpinelli
- Dermatology Unit, Department of Health Sciences, University of Florence Medical School, Florence, Italy
| | - Rudi Stadler
- Dept. Dermatology, Venerology, Allergology and Phlebology, Johannes Wesling Klinikum Minden, University Clinic Ruhr-Universität Bochum, Minden, Germany
| | - Katrin Kerl
- Dept. of Dermatology, Ludwig-Maximilian University Hospital of Munich, Munich, Germany
| | - Pietro Quaglino
- Dermatologic Clinic, Dept Medical Sciences, University of Turin Medical School, Torino, Italy
| | - Jinran Lin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lianjun Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Michaela Beer
- Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | - Patrick Emanuel
- Clinica Ricarda Palma, Lima, Peru and University of Auckland, Auckland, New Zealand
| | - Stephane Dalle
- Unit of Dermatology, Cancer Research center of Lyon, Hôpital Lyon Sud, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, France
| | - Alistair Robson
- Institute of Oncology, Lisbon, Portugal, Portugal.,LDPath, London, UK
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15
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Oschlies I, Wehkamp U. Cutaneous B cell lymphomas: standards in diagnostic and clinical work‐up. Hints, pitfalls and recent advances. Histopathology 2021; 80:184-195. [DOI: 10.1111/his.14556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Ilske Oschlies
- Department of Pathology, Hematopathology and Lymph node Registry University Hospitals Schleswig‐Holstein Christian‐Albrecht‐University Kiel Germany
| | - Ulrike Wehkamp
- Department of Dermatology and Allergology University Hospitals Schleswig‐Holstein Christian‐Albrecht‐University Kiel Germany
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16
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Nicolay JP, Albrecht JD, Assaf C, Dippel E, Stadler R, Wehkamp U, Wobser M, Guelow K, Goerdt S, Krammer PH. Dimethyl fumarate (DMF) therapy in CTCL: results from a clinical phase II study. Eur J Cancer 2021; 156 Suppl 1:S21-S22. [PMID: 34649646 DOI: 10.1016/s0959-8049(21)00666-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jan P Nicolay
- Department of Dermatology, Venereology and Allergy, University Medical Center Mannheim/Ruprecht Karls University of Heidelberg, Mannheim, Germany; Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany; Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jana D Albrecht
- Department of Dermatology, Venereology and Allergy, University Medical Center Mannheim/Ruprecht Karls University of Heidelberg, Mannheim, Germany; Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany; Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Klinikum Krefeld, Krefeld, Germany
| | - Edgar Dippel
- Department of Dermatology, Ludwigshafen Medical Center, Ludwigshafen, Germany
| | - Rudolf Stadler
- University Clinic for Dermatology, Johannes Wesling Medical Center, Minden, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marion Wobser
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Karsten Guelow
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergy, University Medical Center Mannheim/Ruprecht Karls University of Heidelberg, Mannheim, Germany
| | - Peter H Krammer
- Department of Immunogenetics D030, German Cancer Research Center, Heidelberg, Germany
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Molloy K, Jonak C, Porkert S, Knobler R, Guenova E, Fassnacht C, Woei-A-Ji FSH, Busschots AM, Bervoets A, Hauben E, Cowan R, Papadavid E, Beylot-Barry M, Berti E, Violetti SA, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches JA, Scarisbrick J. An update on health-related quality of life from the PROCLIPI study. Eur J Cancer 2021. [DOI: 10.1016/s0959-8049(21)00681-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Molloy K, Oerlemans S, Jonak C, Porkert S, Wehkamp U, Guenova E, Fassnacht C, Cozzio A, Zeller T, Quaglino P, Scarisbrick J. Development of EORTC/CLTF questionnaire to assess HRQOL in primary cutaneous T-cell and B-cell lymphomas: phase I. Eur J Cancer 2021. [DOI: 10.1016/s0959-8049(21)00682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Walker CJ, Jost M, Harder SO, Schladetzky J, Struder M, Mischinski M, Birchmeier M, Handel H, Wehkamp U. Assessment of skin involvement in cutaneous T-cell lymphoma using convolutional neural networks. Eur J Cancer 2021. [DOI: 10.1016/s0959-8049(21)00657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Blazejak C, Stranzenbach R, Klemke CD, Frenzel AK, Mitteldorf C, Nicolay JP, Wobser M, Schrüfer P, Stadler R, Gosmann J, Wehkamp U, Stendel S, Booken N, Kreuter A, Dippel E, Weyermann M, Assaf C. Response to brentuximab vedotin in advanced stage MF/Sézary syndrome with low CD-30 expression: “real-life” data of the German Cutaneous Lymphoma Network. Eur J Cancer 2021. [DOI: 10.1016/s0959-8049(21)00656-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Blazejak C, Stranzenbach R, Gosman J, Gambichler T, Wehkamp U, Stendel S, Klemke CD, Wobser M, Olk J, Nicolay JP, Weyermann M, Stadler R, Assaf C. Clinical Outcomes of Advanced-Stage Cutaneous Lymphoma under Low-Dose Gemcitabine Treatment: Real-Life Data from the German Cutaneous Lymphoma Network. Dermatology 2021; 238:498-506. [PMID: 34474414 DOI: 10.1159/000517830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Gemcitabine is an effective single-agent chemotherapy used in advanced stages of cutaneous T-cell lymphoma (CTCL). However, gemcitabine used in the current standard regimen is frequently associated with adverse events (AE), such as an increased risk for myelosuppression and severe infections. OBJECTIVES We investigated in this retrospective study the effect of low-dose gemcitabine in pretreated advanced-stage CTCL and in blastic plasmacytoid dendritic cell neoplasia (BPDCN) regarding overall response (OR), progression-free survival (PFS), and AE. MATERIAL AND METHODS A retrospective, multicenter study was conducted on 64 CTCL and BPDCN patients treated with gemcitabine in average absolute dosage of 1,800 mg/m2 per cycle, which is 50% lower compared to standard dosage of 3,600 mg/m2 per cycle (1,200 mg/m2 day 1, 8, 15). Evaluation of response to therapy and AE was done 4-6 weeks after the sixth cycle. RESULTS OR was 62% with 11% demonstrating a complete response. The median time of PFS was 12 months and median time to next treatment was 7 months. Only 3/63 patients showed serious side effects, e.g., port infection or acute renal failure. Almost 73% of the patients experienced minor to moderate side effects (CTCAE grade 0-2). Fatigue (27.2%), fever (22.7%), and mild blood count alteration (18.2%) were the most common AE. CONCLUSIONS This retrospective analysis supports the use of low-dose gemcitabine therapy in CTCL, demonstrating with 62% OR and PFS of 12 months an almost identical response rate and survival as compared to the standard dose therapy reported in previous studies but with a significantly improved safety profile and tolerability.
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Affiliation(s)
- Christoph Blazejak
- Department of Dermatology HELIOS Klinikum Krefeld, Academic Teaching Hospital of the University of Aachen, Aachen, Germany
| | - Rene Stranzenbach
- Universitätsklinik für Dermatologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - Janika Gosman
- Universitätsklinik für Dermatologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - Thilo Gambichler
- Department of Dermatology, Universitätsklinikum Bochum, Bochum, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sarja Stendel
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Germany
| | - Marion Wobser
- Department of Dermatology, Universitätsklinik Würzburg, Würzburg, Germany
| | - Joanna Olk
- Department of Dermatology, Universitätsklinik Würzburg, Würzburg, Germany
| | - Jan P Nicolay
- Department of Dermatology Universitätsmedizin Mannheim, Mannheim, Germany
| | - Maria Weyermann
- Niederrhein University of Applied Sciences, Faculty of Health Care, Krefeld, Germany
| | - Rudolf Stadler
- Universitätsklinik für Dermatologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - Chalid Assaf
- Department of Dermatology HELIOS Klinikum Krefeld, Academic Teaching Hospital of the University of Aachen, Aachen, Germany.,Department of Dermatology, Charité -Universitätsmedizin Berlin, Berlin, Germany
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22
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Grünewald M, Stölzl D, Wehkamp U, Weichenthal M, Kaeding M, Scharz T, Heine G. Role of Eosinophils in Angiolymphoid Hyperplasia With Eosinophilia. JAMA Dermatol 2021; 157:1241-1243. [PMID: 34379097 DOI: 10.1001/jamadermatol.2021.2732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Marlena Grünewald
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Dora Stölzl
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ulrike Wehkamp
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Michael Weichenthal
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Merit Kaeding
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Thomas Scharz
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Guido Heine
- Division of Allergy, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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23
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Wehkamp U, Jost M, Gosmann J, Grote U, Bernard M, Stadler R. Management der Chlormethin-Gel-Behandlung bei Patienten mit Mycosis fungoides in zwei deutschen Hautlymphom-Zentren. J Dtsch Dermatol Ges 2021; 19:1057-1060. [PMID: 34288486 DOI: 10.1111/ddg.14462_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ulrike Wehkamp
- Klinik für Dermatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Marion Jost
- Klinik für Dermatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Janika Gosmann
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr-Universität Bochum, Minden
| | - Uta Grote
- Klinik für Dermatologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Michaela Bernard
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr-Universität Bochum, Minden
| | - Rudolf Stadler
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr-Universität Bochum, Minden
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24
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Brinker TJ, Kiehl L, Schmitt M, Jutzi TB, Krieghoff-Henning EI, Krahl D, Kutzner H, Gholam P, Haferkamp S, Klode J, Schadendorf D, Hekler A, Fröhling S, Kather JN, Haggenmüller S, von Kalle C, Heppt M, Hilke F, Ghoreschi K, Tiemann M, Wehkamp U, Hauschild A, Weichenthal M, Utikal JS. Deep learning approach to predict sentinel lymph node status directly from routine histology of primary melanoma tumours. Eur J Cancer 2021; 154:227-234. [PMID: 34298373 DOI: 10.1016/j.ejca.2021.05.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/28/2022]
Abstract
AIM Sentinel lymph node status is a central prognostic factor for melanomas. However, the surgical excision involves some risks for affected patients. In this study, we therefore aimed to develop a digital biomarker that can predict lymph node metastasis non-invasively from digitised H&E slides of primary melanoma tumours. METHODS A total of 415 H&E slides from primary melanoma tumours with known sentinel node (SN) status from three German university hospitals and one private pathological practice were digitised (150 SN positive/265 SN negative). Two hundred ninety-one slides were used to train artificial neural networks (ANNs). The remaining 124 slides were used to test the ability of the ANNs to predict sentinel status. ANNs were trained and/or tested on data sets that were matched or not matched between SN-positive and SN-negative cases for patient age, ulceration, and tumour thickness, factors that are known to correlate with lymph node status. RESULTS The best accuracy was achieved by an ANN that was trained and tested on unmatched cases (61.8% ± 0.2%) area under the receiver operating characteristic (AUROC). In contrast, ANNs that were trained and/or tested on matched cases achieved (55.0% ± 3.5%) AUROC or less. CONCLUSION Our results indicate that the image classifier can predict lymph node status to some, albeit so far not clinically relevant, extent. It may do so by mostly detecting equivalents of factors on histological slides that are already known to correlate with lymph node status. Our results provide a basis for future research with larger data cohorts.
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Affiliation(s)
- Titus J Brinker
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.
| | - Lennard Kiehl
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Max Schmitt
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Tanja B Jutzi
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Eva I Krieghoff-Henning
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Dieter Krahl
- Private Laboratory of Dermatohistopathology, Mönchhofstraße 52, 69120, Heidelberg, Germany
| | - Heinz Kutzner
- Dermatopathology Laboratory, Friedrichshafen, Germany
| | - Patrick Gholam
- Department of Dermatology, University Hospital Heidelberg, Heidelberg. Germany
| | - Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Joachim Klode
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Achim Hekler
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Stefan Fröhling
- Translational Medical Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
| | - Jakob N Kather
- Translational Medical Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany; Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Sarah Haggenmüller
- Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Christof von Kalle
- Department of Clinical-Translational Sciences, Charité University Medicine and Berlin Institute of Health (BIH), Berlin, Germany
| | - Markus Heppt
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Franz Hilke
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
| | | | - Ulrike Wehkamp
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Axel Hauschild
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Jochen S Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; Department of Dermatology, University Hospital (UKSH), Kiel, Germany
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25
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Bohne AS, Dietrich C, Morrison K, Schwarz T, Wehkamp U, Kaeding M. Two cases of quinine-induced fixed 'drug' eruption induced by long drinks. J Eur Acad Dermatol Venereol 2021; 35:e774-e776. [PMID: 34138490 DOI: 10.1111/jdv.17453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A S Bohne
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Dietrich
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - K Morrison
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Schwarz
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - U Wehkamp
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Kaeding
- Department of Dermatology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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26
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Wehkamp U, Jost M, Gosmann J, Grote U, Bernard M, Stadler R. Management of chlormethine gel treatment in mycosis fungoides patients in two German skin lymphoma centers. J Dtsch Dermatol Ges 2021; 19:1057-1059. [PMID: 33942508 DOI: 10.1111/ddg.14462] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marion Jost
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Janika Gosmann
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - Uta Grote
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Michaela Bernard
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - Rudolf Stadler
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
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27
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Quaglino P, Prince H, Cowan R, Vermeer M, Papadavid L, Bagot M, Servitjie O, Berti E, Guenova E, Stadler R, Querfeld C, Busschots A, Hodak E, Patsatsi A, Sanches J, Maule M, Yoo J, Kevin M, Fava P, Ribero S, Zocchi L, Rubatto M, Fierro M, Wehkamp U, Marshalko M, Mitteldorf C, Akilov O, Ortiz-Romero P, Estrach T, Vakeva L, Enz P, Wobser M, Bayne M, Jonak C, Rubeta M, Forbes A, Bates A, Battistella M, Amel-Kashipaz R, Vydianath B, Combalia A, Georgiou E, Hauben E, Hong E, Jost M, Knobler R, Amitay-Laish I, Miyashiro D, Cury-Martins J, Martinez X, Muniesa C, Prag-Naveh H, Nikolaou V, Quint K, Ram-Wolff C, Rieger K, Stranzenbach R, Szepesi Á, Alberti-Violetti S, Felicity E, Cerroni L, Kempf W, Whittaker S, Willemze R, Kim Y, Scarisbrick J. Treatment of early-stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study. Br J Dermatol 2021; 184:722-730. [PMID: 32479678 PMCID: PMC7704558 DOI: 10.1111/bjd.19252] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. Here we examine front-line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF). OBJECTIVES To identify (i) differences in first-line approaches according to tumour-nodes-metastasis-blood (TNMB) staging; (ii) parameters related to a first-line systemic approach and (iii) response rates and QoL measures. METHODS In total, 395 newly diagnosed patients with early-stage MF (stage IA-IIA) were recruited from 41 centres in 17 countries between 1 January 2015 and 31 December 2018 following central clinicopathological review. RESULTS The most common first-line therapy was skin-directed therapy (SDT) (322 cases, 81·5%), while a smaller percentage (44 cases, 11·1%) received systemic therapy. Expectant observation was used in 7·3%. In univariate analysis, the use of systemic therapy was significantly associated with higher clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA-IB vs. IIA, P < 0·001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0·001), higher modified Severity Weighted Assessment Tool (> 10, 15%; ≤ 10, 7%; P = 0·01) and folliculotropic MF (FMF) (24% vs. 12%, P = 0·001). Multivariate analysis demonstrated significant associations with the presence of plaques (T1b/T2b vs. T1a/T2a, odds ratio 3·07) and FMF (odds ratio 2·83). The overall response rate (ORR) to first-line SDT was 73%, while the ORR to first-line systemic treatments was lower (57%) (P = 0·027). Health-related QoL improved significantly both in patients with responsive disease and in those with stable disease. CONCLUSIONS Disease characteristics such as presence of plaques and FMF influence physician treatment choices, and SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early-stage MF need to address these issues.
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Affiliation(s)
- P. Quaglino
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - H.M. Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - R. Cowan
- Christie Hospital, Manchester UK
| | - M. Vermeer
- Leiden University Medical Centre, The Netherlands
| | | | - M. Bagot
- Hospital St Louis, Paris, France
| | - O. Servitjie
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - R. Stadler
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - C. Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | | | - E. Hodak
- Rabin Medical Center, Tel Aviv University, Israel
| | - A. Patsatsi
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - J. Sanches
- University of Sao Paulo Medical School, Brazil, South America
| | - M. Maule
- Cancer Epidemiology Unit, Department Medical Sciences, University of Turin, Italy
| | - J. Yoo
- University Hospitals Birmingham, UK
| | - M. Kevin
- University Hospitals Birmingham, UK
| | - P. Fava
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - S. Ribero
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - L. Zocchi
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M. Rubatto
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M.T. Fierro
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - U. Wehkamp
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - C. Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Center Göttingen, Germany
| | - O. Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, USA
| | | | - T. Estrach
- Hospital Clinico, University of Barcelona, Spain
| | - L. Vakeva
- Helsinki University Central Hospital, Finland
| | - P.A. Enz
- Hospital Italiano De Buenos Aires, Argentina, South America
| | - M. Wobser
- University Hospital Wuerzburg, Germany
| | | | - C. Jonak
- Dept of Dermatology, Medical University of Vienna, Austria
| | - M. Rubeta
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford UK
| | | | - A. Bates
- University Hospital Southampton, Southampton, UK
| | | | | | | | - A. Combalia
- Hospital Clinico, University of Barcelona, Spain
| | - E. Georgiou
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - E. Hauben
- Belgium University Hospitals Leuven, Leuven, Belgium
| | | | - M. Jost
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R. Knobler
- Dept of Dermatology, Medical University of Vienna, Austria
| | | | - D. Miyashiro
- University of Sao Paulo Medical School, Brazil, South America
| | - J. Cury-Martins
- University of Sao Paulo Medical School, Brazil, South America
| | - X. Martinez
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | - C. Muniesa
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - K. Quint
- Leiden University Medical Centre, The Netherlands
| | | | | | - R. Stranzenbach
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - Á. Szepesi
- Semmelweis University, Budapest, Hungary
| | | | | | - L. Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | - W. Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zurich, Switzerland
| | - S. Whittaker
- Kings College London, Guys and St Thomas NHS Foundation Trust, London
| | - R. Willemze
- Leiden University Medical Centre, The Netherlands
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28
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Nielsen PR, Eriksen JO, Sørensen MD, Wehkamp U, Lindahl LM, Bzorek M, Iversen L, Woetman A, Ødum N, Litman T, Gjerdrum LMR. Role of B-cells in Mycosis Fungoides. Acta Derm Venereol 2021; 101:adv00413. [PMID: 33686443 PMCID: PMC9366504 DOI: 10.2340/00015555-3775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. The inflammatory micro-environment in mycosis fungoides is complex. There is accumulating evidence that the neoplastic T-cells take control of the microenvironment and thereby promote their own expansion by suppressing cellular immunity. B-cells have proved to be upregulated in large-cell transformed mycosis fungoides, and could potentially play a role in disease progression. To investigate the presence of B-cells in mycosis fungoides compared with controls, this study analysed 85 formalin-fixed and paraffin-embedded mycosis fungoides biopsies. MS4A1 gene expression was significantly upregulated in mycosis fungoides compared with controls (p < 0.0001) and further upregulated in disease progression, (p = 0.001). Digital quantification of PAX5+/CD20+ cells confirmed the increased presence of B-cells in mycosis fungoides compared with controls. No co-labelling of CD3/CD20 was observed in the neoplastic T-cells. This study found a significantly increased presence of B-cells in the tumour-associated microenvironment in mycosis fungoides. These findings could potentially lead to new treatment strategies for mycosis fungoides.
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Affiliation(s)
- Pia Rude Nielsen
- Department of Pathology, Zealand University Hospital, DK-4000 Roskilde, Denmark. E-mail:
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Hodak E, Sherman S, Papadavid E, Bagot M, Querfeld C, Quaglino P, Prince HM, Ortiz-Romero PL, Stadler R, Knobler R, Guenova E, Estrach T, Patsatsi A, Leshem YA, Prague-Naveh H, Berti E, Alberti-Violetti S, Cowan R, Jonak C, Nikolaou V, Mitteldorf C, Akilov O, Geskin L, Matin R, Beylot-Barry M, Vakeva L, Sanches JA, Servitje O, Weatherhead S, Wobser M, Yoo J, Bayne M, Bates A, Dunnill G, Marschalko M, Buschots AM, Wehkamp U, Evison F, Hong E, Amitay-Laish I, Stranzenbach R, Vermeer M, Willemze R, Kempf W, Cerroni L, Whittaker S, Kim YH, Scarisbrick JJ. Should we be imaging lymph nodes at initial diagnosis of early-stage mycosis fungoides? Results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) international study. Br J Dermatol 2021; 184:524-531. [PMID: 32574377 DOI: 10.1111/bjd.19303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early-stage mycosis fungoides (MF) includes involvement of dermatopathic lymph nodes (LNs) or early lymphomatous LNs. There is a lack of unanimity among current guidelines regarding the indications for initial staging imaging in early-stage presentation of MF in the absence of enlarged palpable LNs. OBJECTIVES To investigate how often imaging is performed in patients with early-stage presentation of MF, to assess the yield of LN imaging, and to determine what disease characteristics promoted imaging. METHODS A review of clinicopathologically confirmed newly diagnosed patients with cutaneous patch/plaque (T1/T2) MF from PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) data. RESULTS PROCLIPI enrolled 375 patients with stage T1/T2 MF: 304 with classical MF and 71 with folliculotropic MF. Imaging was performed in 169 patients (45%): 83 with computed tomography, 18 with positron emission tomography-computed tomography and 68 with ultrasound. Only nine of these (5%) had palpable enlarged (≥ 15 mm) LNs, with an over-representation of plaques, irrespectively of the 10% body surface area cutoff that distinguishes T1 from T2. Folliculotropic MF was not more frequently imaged than classical MF. Radiologically enlarged LNs (≥ 15 mm) were detected in 30 patients (18%); only seven had clinical lymphadenopathy. On multivariate analysis, plaque presentation was the sole parameter significantly associated with radiologically enlarged LNs. Imaging of only clinically enlarged LNs upstaged 4% of patients (seven of 169) to at least IIA, whereas nonselective imaging upstaged another 14% (24 of 169). LN biopsy, performed in eight of 30 patients, identified N3 (extensive lymphomatous involvement) in two and N1 (dermatopathic changes) in six. CONCLUSIONS Physical examination was a poor determinant of LN enlargement or involvement. Presence of plaques was associated with a significant increase in identification of enlarged or involved LNs in patients with early-stage presentation of MF, which may be important when deciding who to image. Imaging increases the detection rate of stage IIA MF, and identifies rare cases of extensive lymphomatous nodes, upstaging them to advanced-stage IVA2.
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Affiliation(s)
- E Hodak
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Sherman
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Papadavid
- Athens University Medical School, Athens, Greece
| | - M Bagot
- Hospital St Louis, Paris, France
| | - C Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - P Quaglino
- Dermatologic Clinic, University of Turin Medical School, Turin, Italy
| | - H M Prince
- Sir Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - P L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain
| | - R Stadler
- Johannes Wesling University Medical Centre, Minden, Germany
| | - R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Guenova
- University Hospital Zurich, Zurich, Switzerland
| | - T Estrach
- Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - A Patsatsi
- Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Y A Leshem
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Prague-Naveh
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Berti
- University of Milan, Milan, Italy
| | | | - R Cowan
- Christie Hospital, Manchester, UK
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Nikolaou
- Athens University Medical School, Athens, Greece
| | - C Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Centre Göttingen, Göttingen, Germany
| | - O Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, PA, USA
| | - L Geskin
- University of Columbia, New York, NY, USA
| | - R Matin
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - L Vakeva
- Helsinki University Central Hospital, Helsinki, Finland
| | - J A Sanches
- University of São Paulo Medical School, São Paulo, SP, Brazil
| | - O Servitje
- Hospital Universatari de Bellvitge, Barcelona, Spain
| | | | - M Wobser
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - J Yoo
- University Hospital Birmingham, Birmingham, UK
| | | | - A Bates
- University Hospital Southampton, Southampton, UK
| | - G Dunnill
- University Hospital Bristol, Bristol, UK
| | | | | | - U Wehkamp
- University Hospital Kiel, Kiel, Germany
| | - F Evison
- University Hospital Birmingham, Birmingham, UK
| | - E Hong
- Stanford University Medical Center, Stanford, CA, USA
| | - I Amitay-Laish
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Stranzenbach
- Johannes Wesling University Medical Centre, Minden, Germany
| | - M Vermeer
- Leiden University Medical Centre, Leiden, the Netherlands
| | - R Willemze
- Leiden University Medical Centre, Leiden, the Netherlands
| | - W Kempf
- Kempf and PFlatz, Histologische Diagnostik, Zurich, Switzerland
| | - L Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | | | - Y H Kim
- Stanford University Medical Center, Stanford, CA, USA
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30
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Wehkamp U, Mitteldorf C, Stendel S, Stranzenbach R, Nicolay JP, Wobser M, Weichenthal M, Schneiderbauer R, Klemke CD, Hillen U, Kempf W, Assaf C. Most rare subtypes of cutaneous lymphoma display variable CD30 expression: analysis of the German Cutaneous Lymphoma Network. Br J Dermatol 2021; 185:228-230. [PMID: 33480069 DOI: 10.1111/bjd.19823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Affiliation(s)
- U Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Mitteldorf
- Department of Dermatology, University Medical Center Goettingen, Germany
| | - S Stendel
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R Stranzenbach
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - J P Nicolay
- Department of Dermatology, University Hospital Mannheim, Germany
| | - M Wobser
- Department of Dermatology, University Hospital Würzburg, Germany
| | - M Weichenthal
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - C-D Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Germany
| | - U Hillen
- Department of Dermatology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - W Kempf
- Department of Dermatology, University Hospital Zurich, Switzerland.,Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | - C Assaf
- Department of Dermatology, Helios-Klinikum Krefeld, Germany
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31
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Jost M, Schwarz T, Wehkamp U. Maculopapular rash upon antibiotic therapy in a patient with rheumatoid arthritis. Int J Dermatol 2020; 60:e206-e207. [PMID: 33179772 DOI: 10.1111/ijd.15305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Marion Jost
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thomas Schwarz
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University-Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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32
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Nielsen PR, Eriksen JO, Lindahl LM, Wehkamp U, Bzorek M, Andersen G, Woetmann A, Iversen L, Ødum N, Litman T, Gjerdrum LMR. Diagnostic Two-Gene Classifier in Early-Stage Mycosis Fungoides: A Retrospective Multicenter Study. J Invest Dermatol 2020; 141:213-217.e5. [PMID: 32454067 DOI: 10.1016/j.jid.2020.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Pia Rude Nielsen
- Department of Pathology, Zealand University Hospital, Denmark; Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | | | | | - Ulrike Wehkamp
- Department of Dermatology, University Hospital, Schleswig-Holstein, Kiel, Germany
| | - Michael Bzorek
- Department of Pathology, Zealand University Hospital, Denmark
| | - Gitte Andersen
- Department of Pathology, Zealand University Hospital, Denmark
| | - Anders Woetmann
- Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Ødum
- Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | - Thomas Litman
- Leo Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | - Lise Mette Rahbek Gjerdrum
- Department of Pathology, Zealand University Hospital, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
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33
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Brüggen MC, Valencak J, Stranzenbach R, Li N, Stadler R, Jonak C, Bauer W, Porkert S, Blaschke A, Meiss F, Nicolay JP, Wehkamp U, Schlaak M, Nguyen VA, Romani N, Cozzio A, Gayathri N, Dimitriou F, French LE, Dummer R, Guenova E. Clinical diversity and treatment approaches to blastic plasmacytoid dendritic cell neoplasm: a retrospective multicentre study. J Eur Acad Dermatol Venereol 2020; 34:1489-1495. [PMID: 31955469 DOI: 10.1111/jdv.16215] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/04/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, aggressive type of haematologic precursor malignancy primarily often manifesting in the skin. We sought to provide a thorough clinical characterization and report our experience on therapeutic approaches to BPDCN. METHODS In the present multicentric retrospective study, we collected all BPDCN cases occurring between 05/1999 and 03/2018 in 10 secondary care centres of the German-Swiss-Austrian cutaneous lymphoma working group. RESULTS A total of 37 BPDCN cases were identified and included. Almost 90% of the patients had systemic manifestations (bone marrow, lymph nodes, peripheral blood) in addition to skin involvement. The latter presented with various types of cutaneous lesions: nodular (in more than 2/3) and bruise-like (in 1/3) skin lesions, but also maculopapular exanthema (in circa 1/6). Therapeutically, 22 patients received diverse combinations of chemotherapeutic regimens and/or radiotherapy. Despite initial responses, all of them ultimately relapsed and died from progressive disease. Eleven patients underwent haematopoietic stem cell transplantation (HSCT; autologous HSCT n = 3, allo-HSCT n = 8). The mortality rate among HSCT patients was only 33.33% with a median survival time of 60.5 months. CONCLUSION Our study demonstrates the clinical diversity of cutaneous BPDCN manifestations and the positive development observed after the introduction of HSCT.
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Affiliation(s)
- M-C Brüggen
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Medical Campus Davos, Davos, Switzerland
| | - J Valencak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - R Stranzenbach
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - N Li
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - R Stadler
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - W Bauer
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - S Porkert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Blaschke
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - F Meiss
- Department of Dermatology and Venereology, Faculty of Medicine, University Medical Center - University of Freiburg, Freiburg, Germany
| | - J P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - U Wehkamp
- Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - M Schlaak
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - V A Nguyen
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - N Romani
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - A Cozzio
- Department of Dermatology, Venereology and Allergology, Canton Hospital of St. Gallen, St. Gallen, Switzerland
| | - N Gayathri
- Department for Hematology, University Hospital of Zurich, Zurich, Switzerland
| | - F Dimitriou
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - L E French
- Department of Dermatology and Allergology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - R Dummer
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - E Guenova
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
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34
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. A study of quality of life in people with mycosis fungoides and Sézary syndrome. Br J Dermatol 2020. [DOI: 10.1111/bjd.18827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Jost M, Wehkamp U, Brasch J, Röcken C, Egberts F. Tumor an der Flanke. J Dtsch Dermatol Ges 2020; 18:271-274. [DOI: 10.1111/ddg.14038_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Marion Jost
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Campus Kiel
| | - Ulrike Wehkamp
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Campus Kiel
| | - Jochen Brasch
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Campus Kiel
| | - Christoph Röcken
- Institut für PathologieUniversitätsklinikum Schleswig‐Holstein Campus Kiel
| | - Friederike Egberts
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Campus Kiel
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36
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. 样肉芽肿和 Sézary 综合征患者生活质量研究. Br J Dermatol 2020. [DOI: 10.1111/bjd.18840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Jost M, Wehkamp U, Brasch J, Röcken C, Egberts F. Tumor on the flank. J Dtsch Dermatol Ges 2020; 18:271-273. [PMID: 32065726 DOI: 10.1111/ddg.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marion Jost
- Department of Dermatology, Venereology and Allergology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Venereology and Allergology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jochen Brasch
- Department of Dermatology, Venereology and Allergology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Friederike Egberts
- Department of Dermatology, Venereology and Allergology, University Medical Center of Schleswig-Holstein, Campus Kiel, Kiel, Germany
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38
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Bohne AS, Schwarz T, Wehkamp U. Disseminierte Blasen und Malaise. J Dtsch Dermatol Ges 2019; 17:1294-1297. [PMID: 31885167 DOI: 10.1111/ddg.13938_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ann-Sophie Bohne
- Klinik für Dermatologie, Universitätsklinik Schleswig-Holstein, Campus Kiel, Kiel
| | - Thomas Schwarz
- Klinik für Dermatologie, Universitätsklinik Schleswig-Holstein, Campus Kiel, Kiel
| | - Ulrike Wehkamp
- Klinik für Dermatologie, Universitätsklinik Schleswig-Holstein, Campus Kiel, Kiel
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39
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Nielsen PR, Eriksen JO, Wehkamp U, Lindahl LM, Gniadecki R, Fogh H, Fabricius S, Bzorek M, Ødum N, Gjerdrum LM. Clinical and Histological Characteristics of Mycosis Fungoides and Sézary Syndrome: A Retrospective, Single-centre Study of 43 Patients from Eastern Denmark. Acta Derm Venereol 2019; 99:1231-1236. [PMID: 31620804 DOI: 10.2340/00015555-3351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diagnosis of mycosis fungoides and Sézary syndrome can be very challenging. Clinical and histopathological data for patients with mycosis fungoides and Sézary syndrome in Denmark are limited. A retrospective study was performed in Region Zealand, Denmark from 1990 to 2016. A total of 43 patients with mycosis fungoides or Sézary syndrome were identified during the period. At the time of diagnosis the patients' mean age was 64.3 years and 74.5% had early-stage (≤IIA) disease. The mean time from onset of skin disease to diagnosis was 4.4 years. Surprisingly, 43% progressed to a higher disease stage, and risk of disease progression was higher for stage IB than IA (p = 0.01). All cases displayed some degree of epidermotropism and the infiltrates consisted of pleomorphic lymphocytes with a T-helper (CD4+/CD8-) phenotype. This study describes, for the first time, all aspects of clinical and histopathological findings in patients with mycosis fungoides and Sézary syndrome in a well-characterized Danish cohort.
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Affiliation(s)
- Pia Rude Nielsen
- Department of Pathology, Zealand University Hospital, DK-4000 Roskilde, Denmark.
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40
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Mucha S, Baurecht H, Novak N, Rodríguez E, Bej S, Mayr G, Emmert H, Stölzl D, Gerdes S, Jung ES, Degenhardt F, Hübenthal M, Ellinghaus E, Kässens JC, Wienbrandt L, Lieb W, Müller-Nurasyid M, Hotze M, Dand N, Grosche S, Marenholz I, Arnold A, Homuth G, Schmidt CO, Wehkamp U, Nöthen MM, Hoffmann P, Paternoster L, Standl M, Bønnelykke K, Ahluwalia TS, Bisgaard H, Peters A, Gieger C, Waldenberger M, Schulz H, Strauch K, Werfel T, Lee YA, Wolfien M, Rosenstiel P, Wolkenhauer O, Schreiber S, Franke A, Weidinger S, Ellinghaus D. Protein-coding variants contribute to the risk of atopic dermatitis and skin-specific gene expression. J Allergy Clin Immunol 2019; 145:1208-1218. [PMID: 31707051 DOI: 10.1016/j.jaci.2019.10.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/09/2019] [Accepted: 10/07/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Fifteen percent of atopic dermatitis (AD) liability-scale heritability could be attributed to 31 susceptibility loci identified by using genome-wide association studies, with only 3 of them (IL13, IL-6 receptor [IL6R], and filaggrin [FLG]) resolved to protein-coding variants. OBJECTIVE We examined whether a significant portion of unexplained AD heritability is further explained by low-frequency and rare variants in the gene-coding sequence. METHODS We evaluated common, low-frequency, and rare protein-coding variants using exome chip and replication genotype data of 15,574 patients and 377,839 control subjects combined with whole-transcriptome data on lesional, nonlesional, and healthy skin samples of 27 patients and 38 control subjects. RESULTS An additional 12.56% (SE, 0.74%) of AD heritability is explained by rare protein-coding variation. We identified docking protein 2 (DOK2) and CD200 receptor 1 (CD200R1) as novel genome-wide significant susceptibility genes. Rare coding variants associated with AD are further enriched in 5 genes (IL-4 receptor [IL4R], IL13, Janus kinase 1 [JAK1], JAK2, and tyrosine kinase 2 [TYK2]) of the IL13 pathway, all of which are targets for novel systemic AD therapeutics. Multiomics-based network and RNA sequencing analysis revealed DOK2 as a central hub interacting with, among others, CD200R1, IL6R, and signal transducer and activator of transcription 3 (STAT3). Multitissue gene expression profile analysis for 53 tissue types from the Genotype-Tissue Expression project showed that disease-associated protein-coding variants exert their greatest effect in skin tissues. CONCLUSION Our discoveries highlight a major role of rare coding variants in AD acting independently of common variants. Further extensive functional studies are required to detect all potential causal variants and to specify the contribution of the novel susceptibility genes DOK2 and CD200R1 to overall disease susceptibility.
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Affiliation(s)
- Sören Mucha
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Hansjörg Baurecht
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Natalija Novak
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Elke Rodríguez
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Saptarshi Bej
- Department of Systems Biology and Bioinformatics, University of Rostock, Germany
| | - Gabriele Mayr
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Hila Emmert
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dora Stölzl
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sascha Gerdes
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Eun Suk Jung
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany; Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Frauke Degenhardt
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Matthias Hübenthal
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany; Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Jan Christian Kässens
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Lars Wienbrandt
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology and Biobank PopGen, Christian Albrechts University of Kiel, Kiel, Germany
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Ludwig-Maximilians-University Munich, Germany; Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Melanie Hotze
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nick Dand
- School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Sarah Grosche
- Pediatric Allergology, Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Centrum (MDC) for Molecular Medicine, Berlin, Germany
| | - Ingo Marenholz
- Pediatric Allergology, Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany; Max-Delbrück-Centrum (MDC) for Molecular Medicine, Berlin, Germany
| | - Andreas Arnold
- Clinic and Polyclinic of Dermatology, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Carsten O Schmidt
- Institute for Community Medicine, Study of Health in Pomerania/KEF, University Medicine Greifswald, Greifswald, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Lavinia Paternoster
- Medical Research Council (MRC) Integrative Epidemiology Unit, Bristol Medical School, and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, Gentofte, Denmark
| | - Tarunveer S Ahluwalia
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, Gentofte, Denmark; Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, Gentofte, Denmark
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Christian Gieger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Holger Schulz
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Ludwig-Maximilians-University Munich, Germany
| | - Thomas Werfel
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Young-Ae Lee
- Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany; School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Markus Wolfien
- Department of Systems Biology and Bioinformatics, University of Rostock, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Olaf Wolkenhauer
- Department of Systems Biology and Bioinformatics, University of Rostock, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany; First Medical Department, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - David Ellinghaus
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Kiel, Germany.
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Wehkamp U, Kurz K, Kähler K, Weichenthal M. Associated primary tumours in patients with primary cutaneous lymphoma: a single-centre retrospective cohort study. J Eur Acad Dermatol Venereol 2019; 34:e92-e93. [PMID: 31573702 DOI: 10.1111/jdv.15993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- U Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - K Kurz
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - K Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Weichenthal
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
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42
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Bohne AS, Schwarz T, Wehkamp U. Disseminated bullae and malaise. J Dtsch Dermatol Ges 2019; 17:1294-1297. [PMID: 31538722 DOI: 10.1111/ddg.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ann-Sophie Bohne
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thomas Schwarz
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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43
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Seltmann K, Meyer M, Sulcova J, Kockmann T, Wehkamp U, Weidinger S, Auf dem Keller U, Werner S. Humidity-regulated CLCA2 protects the epidermis from hyperosmotic stress. Sci Transl Med 2019; 10:10/440/eaao4650. [PMID: 29743348 DOI: 10.1126/scitranslmed.aao4650] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/16/2018] [Indexed: 12/12/2022]
Abstract
Low environmental humidity aggravates symptoms of the inflammatory skin disease atopic dermatitis (AD). Using mice that develop AD-like signs, we show that an increase in environmental humidity rescues their cutaneous inflammation and associated epidermal abnormalities. Quantitative proteomics analysis of epidermal lysates of mice kept at low or high humidity identified humidity-regulated proteins, including chloride channel accessory 3A2 (CLCA3A2), a protein with previously unknown function in the skin. The epidermis of patients with AD, organotypic skin cultures under dry conditions, and cultured keratinocytes exposed to hyperosmotic stress showed up-regulation of the nonorthologous human homolog CLCA2. Hyperosmolarity-induced CLCA2 expression occurred via p38/c-Jun N-terminal kinase-activating transcription factor 2 signaling. CLCA2 knockdown promoted keratinocyte apoptosis induced by hyperosmotic stress through impairment of cell-cell adhesion. These findings provide a mechanistic explanation for the beneficial effect of high environmental humidity for AD patients and identify CLCA3A2/CLCA2 up-regulation as a mechanism to protect keratinocytes from damage induced by low humidity.
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Affiliation(s)
- Kristin Seltmann
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland
| | - Michael Meyer
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland
| | - Jitka Sulcova
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland
| | - Tobias Kockmann
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland.,Functional Genomics Center Zurich, ETH Zurich/University of Zurich, 8057 Zurich, Switzerland
| | - Ulrike Wehkamp
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Ulrich Auf dem Keller
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland.
| | - Sabine Werner
- Institute of Molecular Health Sciences, Department of Biology, ETH Zurich, 8093 Zurich, Switzerland.
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Drerup KA, Wehkamp U. [Anti-p200 pemphigoid: clinical, diagnostic and therapeutic aspects]. Hautarzt 2019; 71:130-133. [PMID: 31501972 DOI: 10.1007/s00105-019-04478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Anti-p200 pemphigoid is a rare autoimmune blistering dermatosis. The clinical course is heterogeneous. Typically, immunoglobulin G (IgG) antibodies are found on the floor of salt-split skin, which differentiates p200 pemphigoid from bullous pemphigoid. It is necessary to perform immunoblotting and enzyme-linked immunosorbent assays (ELISA) to confirm the diagnosis. Small amounts of dapsone are often sufficient for disease control. The clinical and diagnostic characteristics of anti-p200 pemphigoid and the principles of treatment are presented exemplified by two case reports.
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Affiliation(s)
- Katharina Antonia Drerup
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland.
| | - Ulrike Wehkamp
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland
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45
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Maron RC, Weichenthal M, Utikal JS, Hekler A, Berking C, Hauschild A, Enk AH, Haferkamp S, Klode J, Schadendorf D, Jansen P, Holland-Letz T, Schilling B, von Kalle C, Fröhling S, Gaiser MR, Hartmann D, Gesierich A, Kähler KC, Wehkamp U, Karoglan A, Bär C, Brinker TJ, Schmitt L, Peitsch WK, Hoffmann F, Becker JC, Drusio C, Jansen P, Klode J, Lodde G, Sammet S, Schadendorf D, Sondermann W, Ugurel S, Zader J, Enk A, Salzmann M, Schäfer S, Schäkel K, Winkler J, Wölbing P, Asper H, Bohne AS, Brown V, Burba B, Deffaa S, Dietrich C, Dietrich M, Drerup KA, Egberts F, Erkens AS, Greven S, Harde V, Jost M, Kaeding M, Kosova K, Lischner S, Maagk M, Messinger AL, Metzner M, Motamedi R, Rosenthal AC, Seidl U, Stemmermann J, Torz K, Velez JG, Haiduk J, Alter M, Bär C, Bergenthal P, Gerlach A, Holtorf C, Karoglan A, Kindermann S, Kraas L, Felcht M, Gaiser MR, Klemke CD, Kurzen H, Leibing T, Müller V, Reinhard RR, Utikal J, Winter F, Berking C, Eicher L, Hartmann D, Heppt M, Kilian K, Krammer S, Lill D, Niesert AC, Oppel E, Sattler E, Senner S, Wallmichrath J, Wolff H, Giner T, Glutsch V, Kerstan A, Presser D, Schrüfer P, Schummer P, Stolze I, Weber J, Drexler K, Haferkamp S, Mickler M, Stauner CT, Thiem A. Systematic outperformance of 112 dermatologists in multiclass skin cancer image classification by convolutional neural networks. Eur J Cancer 2019; 119:57-65. [DOI: 10.1016/j.ejca.2019.06.013] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 01/07/2023]
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46
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Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, Servitje O, Berti E, Ortiz-Romero P, Stadler R, Patsatsi A, Knobler R, Guenova E, Child F, Whittaker S, Nikolaou V, Tomasini C, Amitay I, Prag Naveh H, Ram-Wolff C, Battistella M, Alberti-Violetti S, Stranzenbach R, Gargallo V, Muniesa C, Koletsa T, Jonak C, Porkert S, Mitteldorf C, Estrach T, Combalia A, Marschalko M, Csomor J, Szepesi A, Cozzio A, Dummer R, Pimpinelli N, Grandi V, Beylot-Barry M, Pham-Ledard A, Wobser M, Geissinger E, Wehkamp U, Weichenthal M, Cowan R, Parry E, Harris J, Wachsmuth R, Turner D, Bates A, Healy E, Trautinger F, Latzka J, Yoo J, Vydianath B, Amel-Kashipaz R, Marinos L, Oikonomidi A, Stratigos A, Vignon-Pennamen MD, Battistella M, Climent F, Gonzalez-Barca E, Georgiou E, Senetta R, Zinzani P, Vakeva L, Ranki A, Busschots AM, Hauben E, Bervoets A, Woei-A-Jin FJSH, Matin R, Collins G, Weatherhead S, Frew J, Bayne M, Dunnill G, McKay P, Arumainathan A, Azurdia R, Benstead K, Twigger R, Rieger K, Brown R, Sanches JA, Miyashiro D, Akilov O, McCann S, Sahi H, Damasco FM, Querfeld C, Folkes A, Bur C, Klemke CD, Enz P, Pujol R, Quint K, Geskin L, Hong E, Evison F, Vermeer M, Cerroni L, Kempf W, Kim Y, Willemze R. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181:350-357. [PMID: 30267549 DOI: 10.1111/bjd.17258] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survival in mycosis fungoides (MF) is varied and may be poor. The PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study is a web-based data collection system for early-stage MF with legal data-sharing agreements permitting international collaboration in a rare cancer with complex pathology. Clinicopathological data must be 100% complete and in-built intelligence in the database system ensures accurate staging. OBJECTIVES To develop a prognostic index for MF. METHODS Predefined datasets for clinical, haematological, radiological, immunohistochemical, genotypic, treatment and quality of life are collected at first diagnosis of MF and annually to test against survival. Biobanked tissue samples are recorded within a Federated Biobank for translational studies. RESULTS In total, 430 patients were enrolled from 29 centres in 15 countries spanning five continents. Altogether, 348 were confirmed as having early-stage MF at central review. The majority had classical MF (81·6%) with a CD4 phenotype (88·2%). Folliculotropic MF was diagnosed in 17·8%. Most presented with stage I (IA: 49·4%; IB: 42·8%), but 7·8% presented with enlarged lymph nodes (stage IIA). A diagnostic delay between first symptom development and initial diagnosis was frequent [85·6%; median delay 36 months (interquartile range 12-90)]. This highlights the difficulties in accurate diagnosis, which includes lack of a singular diagnostic test for MF. CONCLUSIONS This confirmed early-stage MF cohort is being followed-up to identify prognostic factors, which may allow better management and improve survival by identifying patients at risk of disease progression. This study design is a useful model for collaboration in other rare diseases, especially where pathological diagnosis can be complex.
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Affiliation(s)
- J J Scarisbrick
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - P Quaglino
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H M Prince
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Papadavid
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hodak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Bagot
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Servitje
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Berti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - P Ortiz-Romero
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Stadler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Patsatsi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Knobler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Guenova
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Child
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - S Whittaker
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - V Nikolaou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Tomasini
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - I Amitay
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Prag Naveh
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Ram-Wolff
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Alberti-Violetti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Stranzenbach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - V Gargallo
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Muniesa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Koletsa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Jonak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Porkert
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Mitteldorf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Estrach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Combalia
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Marschalko
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Csomor
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Szepesi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Cozzio
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Dummer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - N Pimpinelli
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - V Grandi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Beylot-Barry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Pham-Ledard
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Wobser
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Geissinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - U Wehkamp
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Weichenthal
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Cowan
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - E Parry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - J Harris
- Member of the UK Cutaneous Lymphoma Group
| | - R Wachsmuth
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - D Turner
- Member of the UK Cutaneous Lymphoma Group
| | - A Bates
- Member of the UK Cutaneous Lymphoma Group
| | - E Healy
- Member of the UK Cutaneous Lymphoma Group
| | - F Trautinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J Latzka
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Yoo
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - B Vydianath
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - R Amel-Kashipaz
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - L Marinos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Oikonomidi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Stratigos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M-D Vignon-Pennamen
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F Climent
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Gonzalez-Barca
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Georgiou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Senetta
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Zinzani
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Vakeva
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Ranki
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A-M Busschots
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Hauben
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Bervoets
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F J S H Woei-A-Jin
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Matin
- Member of the UK Cutaneous Lymphoma Group
| | - G Collins
- Member of the UK Cutaneous Lymphoma Group
| | | | - J Frew
- Member of the UK Cutaneous Lymphoma Group
| | - M Bayne
- Member of the UK Cutaneous Lymphoma Group
| | - G Dunnill
- Member of the UK Cutaneous Lymphoma Group
| | - P McKay
- Member of the UK Cutaneous Lymphoma Group
| | | | - R Azurdia
- Member of the UK Cutaneous Lymphoma Group
| | - K Benstead
- Member of the UK Cutaneous Lymphoma Group
| | - R Twigger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Rieger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Brown
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J A Sanches
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - D Miyashiro
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Akilov
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S McCann
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Sahi
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F M Damasco
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Querfeld
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Folkes
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Bur
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C-D Klemke
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Enz
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Pujol
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Quint
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Geskin
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hong
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Evison
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - M Vermeer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - L Cerroni
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - W Kempf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - Y Kim
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Willemze
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
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Molloy K, Jonak C, Woei‐A‐Jin F, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (
PROCLIPI
) study. Br J Dermatol 2019; 182:770-779. [DOI: 10.1111/bjd.18089] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/01/2023]
Affiliation(s)
- K. Molloy
- University Hospitals Birmingham Birmingham U.K
| | - C. Jonak
- Medical University of Vienna Vienna Austria
| | | | | | | | | | | | - R. Knobler
- Medical University of Vienna Vienna Austria
| | - S. Porkert
- Medical University of Vienna Vienna Austria
| | | | - R. Cowan
- Christie Hospital Manchester U.K
| | | | - M. Beylot‐Barry
- Centre Hospitalier Universitaire Hospital de Bordeaux Bordeaux France
| | - E. Berti
- Department of Dermatology Fondazione Ca’ Granda IRCCS OMP Milan Italy
| | | | - T. Estrach
- Hospital Clinico University of Barcelona Barcelona Spain
| | | | - O. Akilov
- University of Pittsburgh School of Medicine Pittsburgh PA U.S.A
| | - L. Vakeva
- Helsinki University Central Hospital Helsinki Finland
| | - M. Prince
- Peter MacCallum Cancer Centre Melbourne Australia
| | - A. Bates
- University Hospital Southampton Southampton U.K
| | | | | | | | | | - O. Servitje
- Hospital Universatari de Bellvitge Barcelona Spain
| | | | | | - M. Wobser
- University Hospital Würzburg Würzburg Germany
| | - J.A. Sanches
- University of São Paulo Medical School São Paulo Brazil
| | - P. McKay
- Beatson West of Scotland Cancer Centre Glasgow U.K
| | - D. Klemke
- Stadtisches Klinikum Karlsruhe Karlsruhe Germany
| | - C. Peng
- University Hospitals Birmingham Birmingham U.K
| | - A. Howles
- University Hospitals Birmingham Birmingham U.K
| | - J. Yoo
- University Hospitals Birmingham Birmingham U.K
| | - F. Evison
- University Hospitals Birmingham Birmingham U.K
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48
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Tsoi LC, Rodriguez E, Degenhardt F, Baurecht H, Wehkamp U, Volks N, Szymczak S, Swindell WR, Sarkar MK, Raja K, Shao S, Patrick M, Gao Y, Uppala R, Perez White BE, Getsios S, Harms PW, Maverakis E, Elder JT, Franke A, Gudjonsson JE, Weidinger S. Atopic Dermatitis Is an IL-13-Dominant Disease with Greater Molecular Heterogeneity Compared to Psoriasis. J Invest Dermatol 2019; 139:1480-1489. [PMID: 30641038 DOI: 10.1016/j.jid.2018.12.018] [Citation(s) in RCA: 249] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 02/03/2023]
Abstract
Atopic dermatitis (AD) affects up to 20% of children and adults worldwide. To gain a deeper understanding of the pathophysiology of AD, we conducted a large-scale transcriptomic study of AD with deeply sequenced RNA-sequencing samples using long (126-bp) paired-end reads. In addition to the comparisons against previous transcriptomic studies, we conducted in-depth analysis to obtain a high-resolution view of the global architecture of the AD transcriptome and contrasted it with that of psoriasis from the same cohort. By using 147 RNA samples in total, we found striking correlation between dysregulated genes in lesional psoriasis and lesional AD skin with 81% of AD dysregulated genes being shared with psoriasis. However, we described disease-specific molecular and cellular features, with AD skin showing dominance of IL-13 pathways, but with near undetectable IL-4 expression. We also demonstrated greater disease heterogeneity and larger proportion of dysregulated long noncoding RNAs in AD, and illustrated the translational impact, including skin-type classification and drug-target prediction. This study is by far the largest study comparing the AD and psoriasis transcriptomes using RNA sequencing and demonstrating the shared inflammatory components, as well as specific discordant cytokine signatures of these two skin diseases.
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Affiliation(s)
- Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Elke Rodriguez
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Frauke Degenhardt
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Hansjörg Baurecht
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Natalie Volks
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Silke Szymczak
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - William R Swindell
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kalpana Raja
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Shuai Shao
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Matthew Patrick
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Yilin Gao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Ranjitha Uppala
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Spiro Getsios
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Emanual Maverakis
- Department of Dermatology, School of Medicine, UC Davis Medical Center, Sacramento, California, USA
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Andre Franke
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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Wehkamp U, Mitteldorf C, Wobser M, Schneiderbauer R, Hillen U, Stendel S, Stranzenbach R, Nicolay J, Klemke CD, Kempf W, Assaf C. CD30 expression in rare cutaneous lymphomas. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brüggen MC, Valencak J, Stranzenbach R, Stadler R, Jonak C, Bauer W, Porkert S, Blaschke A, Meiss F, Nicolay J, Wehkamp U, Schlaak M, Nguyen VA, Romani N, Cozzio A, Gayathri N, Li N, French L, Dummer R, Guenova E. Clinical diversity and treatment approaches to blastic plasmacytoid dendritic cell neoplasm: a retrospective multicenter study. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30602-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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