Guidelines for the Management of Haematological Malignancies

• in the interim for YCN, a single skin MDT should take responsibility for reviewing patients with
CTCL and the Cookridge MDT will provide the lymphoma MDT review. (Referrals to be sent to
Dr Di Gilson).
• For Humber & Yorkshire Coast Cancer Network, the MDT meeting will be in the new
Oncology/Haematology building at Castle Hill Hospital but until then patients will be reviewed
at the Hull Haematology MDT meeting.
The following patients require referral for central MDT review:
• Stage IA with a solitary lesion, as this may be amenable to cure with radiotherapy
• Stage I B and higher at presentation
• When disease is failing to respond to current treatment, for example:
• disease not controlled with phototherapy
• disease is progressing through systemic therapy
• Toxicity of treatment is unacceptable, for example:
• Where unacceptable doses of phototherapy have proved necessary (>1000 J/cm 2 .)
• PUVA or systemic therapy is not being tolerated
• End stage disease where no further active therapy is being offered
Treatment
• The aim is to control the disease with the minimum of inconvenience and toxicity for the
patient, for all except transformed disease
• There are many treatment options.
• Selection of appropriate treatment is based mainly on clinical stage.
• Other factors may be relevant, e.g. the patient’s age, co-morbid conditions and accessibility of
different treatment approaches.
• Optimal treatment for each patient requires multi-disciplinary co-operation.
• Referral for multi-disciplinary review should be considered.
• Multi-disciplinary clinics take place Cookridge Hospital in Leeds (Dr Di Gilson) or Hull Royal
Infirmary (Dr Russell Patmore).
Guidelines for the Management of Haematological Malignancies
14. CUTANEOUS LYMPHOMA
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