Cutaneous T-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management

Am J Hematol. 2023 Jan;98(1):193-209. doi: 10.1002/ajh.26760. Epub 2022 Oct 20.

Abstract

Disease overview: Cutaneous T-cell lymphomas are a heterogenous group of T-cell neoplasms involving the skin, the majority of which may be classified as Mycosis Fungoides (MF) or Sézary Syndrome (SS).

Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.

Risk-adapted therapy: TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a "risk-adapted," multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin-directed therapies is preferred, as both disease-specific and overall survival for these patients is favorable. In contrast, patients with advanced-stage disease with significant nodal, visceral or the blood involvement are generally approached with systemic therapies, including biologic-response modifiers, histone deacetylase inhibitors, or antibody-based strategies, in an escalating fashion. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Lymphoma, T-Cell, Cutaneous* / diagnosis
  • Lymphoma, T-Cell, Cutaneous* / therapy
  • Mycosis Fungoides* / diagnosis
  • Mycosis Fungoides* / pathology
  • Mycosis Fungoides* / therapy
  • Neoplasm Staging
  • Sezary Syndrome* / diagnosis
  • Sezary Syndrome* / pathology
  • Sezary Syndrome* / therapy
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / therapy