Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
CUTANEOUS LYMPHOMAS
Cancer: Principles and Practice of Oncology. Third Edition. DeVita VT Jr. et al, eds. Philadelphia, Lippincott, p. 1799-808, 1989.. Unique Identifier : AIDSLINE ICDB/90666998 Bunn PA; Fuks Z; Div. of Medical Oncology, Univ. of Colorado, Health Sciences; Center, University Hosp., Denver, CO
Abstract:
T-cell lymphomas are much less common than B-cell lymphomas in patients (pts) in the united States. Cutaneous T-cell lymphoma (CTCL) has an age-adjusted incidence in the United States of 2-3 cases per million persons per year. Acute T-cell leukemia/lymphoma (ATL), which is caused by human T-cell lymphotropic virus (HTLV)-I, is rare, with fewer than 100 cases reported in the literature. It is uncertain whether the incidence is rising because of an increased prevalence of HTLV-I infection. Cutaneous lymphomas are reviewed here under the following headings: classification of T-cell malignancies; clinical features of ATL and low-grade T-cell lymphomas (CTCL); lymphomatoid papulosis and lymphomatoid granulomatosis; therapy of ATL; and therapy of CTCL (radiation therapy, topical and systemic chemotherapy, topical photochemotherapy, combined modality therapy, and biologic and experimental therapies). In the United States, most malignant lymphomas are of B-cell origin, whereas in other parts of the world (eg, Japan), T-cell lymphomas predominate. Pts with low-grade T-cell lymphomas typically have a natural history extending over years to decades, but most pts eventually die of lymphoma or secondary infections unless successfully treated. Therapy of ATL is currently unsatisfactory, and pts have a very poor prognosis. Complete remission has been observed in about 50% of pts given various combination chemotherapy regimens, but long-term remissions are not observed. Because the cutaneous manifestations represent the major clinical manifestations and the most common source of symptoms in CTCL, topical treatments have been the mainstay of CTCL management. Topical treatments with nitrogen mustard, psoralen with UV A light, or photochemotherapy, and electron-beam irradiation have been established as effective, although their impact on survival is still debated. With the increasing realization that CTCL disseminates early, systemic chemotherapy has been increasingly used, but its effectiveness and impact on survival have not been established. Interferon also has been established as an effective systemic agent, with an unknown effect on survival. (96 Refs)
Keywords: Antineoplastic Agents/THERAPEUTIC USE Combined Modality Therapy Human Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/THERAPY Lymphoma/DRUG THERAPY/PATHOLOGY/RADIOTHERAPY/*THERAPY Neoplasm Staging Radiotherapy Dosage Skin/PATHOLOGY Skin Neoplasms/DRUG THERAPY/PATHOLOGY/RADIOTHERAPY/*THERAPY T-Lymphocytes MONOGRAPH REVIEW REVIEW, TUTORIAL 901230
M90C3738
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
