Management of cutaneous B-cell lymphoma: Recommendations of the French cutaneous lymphoma study group

被引:6
作者
Grange, F. [1 ]
D'Incan, M. [2 ]
Ortonne, N. [3 ]
Dalac, S. [4 ]
Laroche, L. [5 ]
Beylot-Barry, M. [6 ]
Delfau-Larue, M. -H. [7 ]
Vergier, B. [8 ]
Bagot, M. [9 ]
机构
[1] Hop Robert Debre, Serv Dermatol, F-51092 Reims, France
[2] Univ Clermont Ferrand 1, CHU, Serv Dermatol, Clermont Ferrand, France
[3] Hop Henri Mondor, Dept Pathol, F-94010 Creteil, France
[4] Hop Bocage, Serv Dermatol, Dijon, France
[5] Hop Avicenne, Serv Dermatol, F-93009 Bobigny, France
[6] Univ Bordeaux 2, Serv Dermatol, CHU Bordeaux, EA 2406, F-33076 Bordeaux, France
[7] Univ Paris Est Creteil Val de Marne, Immunol Lab, Grp Henri Mondor Albert Chenevier, Fac Med,AP HP, Creteil, France
[8] Univ Victor Segalen Bordeaux 2, CHU Bordeaux, Serv Pathol, EA2406, Bordeaux, France
[9] Hop St Louis, Serv Dermatol, INSERM, U976, F-75475 Paris, France
来源
ANNALES DE DERMATOLOGIE ET DE VENEREOLOGIE | 2010年 / 137卷 / 8-9期
关键词
Cutaneous B-cell lymphoma; Recommendations; Staging; Therapy; TREATMENT-OF-CANCER; TNM CLASSIFICATION-SYSTEM; WHO-EORTC CLASSIFICATION; PROGNOSTIC-FACTORS; FOLLOW-UP; LEG TYPE; CLINICOPATHOLOGICAL FEATURES; ANTIBODY RITUXIMAB; MYCOSIS-FUNGOIDES; SEZARY-SYNDROME;
D O I
10.1016/j.annder.2010.04.016
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Aims. - To provide recommendations for the treatment of cutaneous B-cell lymphomas (CBCL). Methods. - Literature review and expert opinions from the French Cutaneous Lymphoma Study Group. Results. - Diagnosis of marginal zone BCL (MZ BCL), centrofollicular BCL (CF BCL) or cutaneous large B-cell lymphoma, leg type (CLBCL, LT) is based on combination of clinical signs and histopathological features, together with B-cell clonality analyses whenever possible. Staging relies on straightforward laboratory examinations and imaging, completed in selected cases with bone marrow biopsy. Treatment may be topical, including excision, curative radiotherapy (30 Gray) or adjunctive/low dose (4 Gray) radiotherapy, topical corticosteroids, interferon or intralesional rituximab; or systemic, using chemotherapy and/or intravenous rituximab. For indolent forms of the disease (MZ CBCL and CF CBCL), curative (30 Gray) may be given as first-line treatment in patients with localized lesions or few scattered skin lesions. For more numerous slow-growing lesions with a low tumour burden, simple monitoring with adjunctive ad hoc local treatment of individual lesions is acceptable. For multiple growing lesions, systemic rituximab or chlorambucil may be proposed. Polychemotherapy should only be used for progressive forms unresponsive to previous therapies. CLBCL LT forms are more aggressive and occur in older subjects. These lymphomas are best treated with age-adapted combinations of polychemotherapies and rituximab. Conclusion. - Appropriate clinical trials are still needed to strengthen the levels of evidence of current recommendations. (C) 2010 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:523 / 531
页数:9
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