1
|
McCusker S, Ngu I. Primary cutaneous lymphomas: exploration of 10-year data from supraregional mutlidisciplinary team meetings in Glasgow, UK. Clin Exp Dermatol 2023; 48:1036-1039. [PMID: 37140442 DOI: 10.1093/ced/llad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/05/2023]
Abstract
Primary cutaneous lymphomas (PCLs) are non-Hodgkin lymphomas, presenting in the skin. They are classified into cutaneous B-cell lymphomas (CBCLs) or cutaneous T-cell lymphomas (CTCLs). The most common CTCL subtypes are mycosis fungoides (MF) and Sézary syndrome (SS). All patient's cases should be discussed at a specialist multidisciplinary team (MDT) meeting. This is the first published review, to our knowledge, of PCL MDT case discussion in the UK. Patient cases between 2008 and 2019 were reviewed to assess: frequency of PCL subtype, documentation of CTCL staging and management of MF/SS. Of 356, 103 (29%) were CBCLs and the majority (n = 200, 56%) were CTCLs. MF/SS was the diagnosis in 120 (34%). Staging was documented in 44% (n = 53) of patients with MF/SS. Management largely followed guidelines for MF/SS, topical corticosteroids were the most common treatment (n = 93, 78%). Frequency of PCL subtype is largely comparable with previously published data. Documentation of CTCL staging is low, but higher than other reports. Our work begins to address the gap in real-world data on CTCLs. A standardized approach to data collection would inform clinical practice.
Collapse
Affiliation(s)
- Sarah McCusker
- Department of Dermatology, West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Ivy Ngu
- Department of Dermatology, Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde Glasgow, UK
| |
Collapse
|
2
|
Dobos G, Pohrt A, Ram-Wolff C, Lebbé C, Bouaziz JD, Battistella M, Bagot M, de Masson A. Epidemiology of Cutaneous T-Cell Lymphomas: A Systematic Review and Meta-Analysis of 16,953 Patients. Cancers (Basel) 2020; 12:cancers12102921. [PMID: 33050643 PMCID: PMC7600606 DOI: 10.3390/cancers12102921] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/24/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Cutaneous T-cell lymphomas (CTCL) are rare malignant diseases. In this study we have compared the cutaneous lymphoma registries of different countries, which included information on at least 100 patients. The frequencies of each CTCL subtype were compared within and between continents. We found that the registries differed importantly in terms of size and quality. Some rare CTCL subtypes, such as NK/T-cell lymphoma or subcutaneous panniculitis-like lymphomas, were more frequent in Asian countries, while others were evenly distributed. We discuss possible reasons for this and provide suggestions on how to build future CTCL registries. Abstract Cutaneous T-cell lymphomas (CTCL) are a heterogenous group of rare diseases. Many studies have reported on local epidemiology or geographic clustering, however we lack information from a global perspective. A systematic review and meta-analysis was conducted in Medline and the Cochrane Library based on a previously registered protocol and according to the preferred reporting of items for systematic reviews and meta-analyses (PRISMA). We selected publications that enrolled at least 100 patients with primary cutaneous lymphomas according to the current classifications. The relative frequencies (proportions) of subtypes were compared between studies and geographic regions in a meta-analysis. In total, 26 studies met our inclusion criteria, reporting on altogether 16,953 patients. Within primary cutaneous lymphomas, CTCL appeared to be 15% more frequent in Asian populations. Mycosis fungoides (MF) accounted for 62% of CTCL, with an important heterogeneity in frequencies between studies and continents. The proportion of Sézary syndrome (SS) was 3%, stable worldwide. Rare CTCL, such as NK/T-cell lymphoma or subcutaneous panniculitis-like lymphoma, were more frequent in Asian studies. This global meta-analysis of CTCL confirmed the predominance of CTCL among primary cutaneous lymphomas (83% on average) in the three analyzed continents, most of which were MF cases. It revealed the same proportions of SS across continents, and the heterogeneity of MF frequencies, suggesting the possible role of environmental factors in the pathophysiology of the latter. Registration number: CRD42020148295 (PROSPERO).
Collapse
Affiliation(s)
- Gabor Dobos
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
| | - Anne Pohrt
- Institute of Biometry and Clinical Epidemiology, Charité-Universitättsmedizin, 10117 Berlin, Germany;
| | - Caroline Ram-Wolff
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
| | - Céleste Lebbé
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
| | - Jean-David Bouaziz
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
| | - Maxime Battistella
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
- Pathology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France
| | - Martine Bagot
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
- Correspondence: ; Tel.: +33-1-5372-2093
| | - Adèle de Masson
- Dermatology Department, Saint-Louis Hospital, AP-HP, 75010 Paris, France; (G.D.); (C.R.-W.); (C.L.); (J.-D.B.); (A.d.M.)
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Institut de Recherche Saint-Louis, 75010 Paris, France;
- Department of Medicine, Université de Paris, 75010 Paris, France
| |
Collapse
|