Abstract
The management of MF-CTCL is based on a 'stage-based' approach and an evaluation by a multidisciplinary team is preferred. Initial treatment in patients with local (patch/plaque) disease includes skin-directed therapies (localized or generalized), with the addition of systemic biologic therapy for refractory, or progressive disease. In patients with unfavorable prognostic features (e.g., folliculotropic or large-cell transformed MF, or B1 involvement) systemic biologic therapies may be introduced earlier in the treatment algorithm.
Highlights
Cutaneous T-cell lymphomas (CTCLs) comprise 70% of all primary cutaneous lymphomas with an estimated annual incidence of 0.3-1 per 100,000 people in the United States of America [4,5]
Current treatment options are “stage-based”, including skin-directed therapies and localized radiation treatment (RT) for early stages and systemic therapy combined with total skin electron irradiation (TSEI) for more advanced stages
TSEI represents a treatment option that has a vital role in the treatment of Mycosis fungoides (MF), with mild and reversible treatment related side effects [9]
Summary
Total Skin Electron Irradiation (TSEI) May Induce Systemic Progression of Mycosis Fungoides (MF) - Cutaneous T-Cell Lymphoma (CTCL). Initial treatment in patients with local (patch/ plaque) disease includes skin-directed therapies (localized or generalized), with the addition of systemic biologic therapy for refractory, or progressive disease. A 75-YOAAM with stage IIB Cutaneous T-Cell Lymphoma had clinically indolent disease for many years. He presented with multiple cutaneous lesions with increasing evolution of his disease. He received TSEI to 18 Gy in 12 fractions followed by additional boost to many sites. TSEI’s impact on systemic progression of MF merits further investigation, especially in the context of clinicopathological evaluation of MF transformation and the potential value of combining novel immunotherapeutic agents like checkpoint inhibitors with RT to potentially further improve outcomes for such patients with aggressive transformation MFCTCL
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