Treatment Options Multiply for Cutaneous T-cell Lymphoma

By Annette M. Boyle

BIRMINGHAM, MI — After decades on the sidelines, research in cutaneous T-cell lymphoma (CTCL) has exploded in recent years, bringing patients with this rare disease new opportunities for treatment.

Increasingly, research is focusing on the “prognostic indicators, how does the disease develop, what distinguishes the variants of the disease and what makes one person’s an indolent disease and another’s life threatening,” said Susan Thornton, chief executive officer of the Cutaneous Lymphoma Foundation.

For the majority of patients with mycosis fungoides, which accounts for about 70% of all CTCL, the disease has a favorable prognosis; it will either never progress or will develop very slowly. About one-third of patients, however, will eventually develop tumor lesions and experience involvement of the blood, lymph nodes, bone marrow or visceral organs. For them, the outlook deteriorates sharply.

More than 50% of mycosis fungoides patients with Stage 3 or 4 disease die of the disease, and median survival is only five years, according to the National Cancer Institute.

A growing number of researchers are working to identify the “telltale signs that a person’s disease is taking a turn for the worse,” Thornton told U.S. Medicine.

Inflammation appears to be one of the critical markers, according to a study recently published in Seminars in Immunopathology. A global team of researchers, including Erik Langhoff, MD, of the James J. Peters VAMC, Bronx, NY, found that the “transition from early indolent to progressive and advanced disease is accompanied by a significant shift in the nature of the tumor-associated inflammation.” 1

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