Mycosis fungoides and Sézary syndrome: 2019 update on diagnosis, risk‐stratification, and management

AC Hristov, T Tejasvi, RA Wilcox - American journal of …, 2019 - Wiley Online Library
AC Hristov, T Tejasvi, RA Wilcox
American journal of hematology, 2019Wiley Online Library
Abstract Disease Overview Cutaneous T‐cell lymphomas (CTCL) are a heterogenous group
of T‐cell neoplasms involving the skin, the majority of which may be classified as Mycosis
fungoides (MF) or Sézary syndrome (SS). Diagnosis The diagnosis of MF or SS requires the
integration of clinical and histopathologic data. Risk‐Adapted Therapy TNMB (tumor, node,
metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms
the basis for a “risk‐adapted,” multi‐disciplinary approach to treatment. For patients with …
Disease Overview
Cutaneous T‐cell lymphomas (CTCL) are a heterogenous group of T‐cell neoplasms involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).
Diagnosis
The diagnosis of MF or SS requires the integration of clinical and histopathologic data.
Risk‐Adapted Therapy
TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multi‐disciplinary approach to treatment. For patients with disease limited to the skin, skin‐directed therapies are preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral or blood involvement are generally approached with systemic therapies. These include biologic‐response modifiers, histone deacetylase (HDAC) inhibitors, or antibody‐based strategies, in an escalating fashion. In highly‐selected patients, allogeneic stem‐cell transplantation may be considered, as this may be curative in some patients.
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