Cutaneous T-cell lymphoma - Lymphoma Association

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people, the average age being about 45. Again, it is more common in men. Crops ofpapules or bigger lumps (nodules), which are often ulcerated in the middle, appearover a period of a few days, usually on an arm or leg or on the trunk. They usually healup over a period of 3–12 weeks, but they can persist for longer than this, and they canleave behind superficial scars. About 1 in 20 people with LyP also develop anothertype of lymphoma as well (such as cutaneous ALCL, mycosis fungoides or Hodgkinlymphoma).No treatment has been shown to change the course of LyP but several of the topicaltreatments, including PUVA and steroid creams, can be used if the nodules areparticularly troublesome. If LyP ‘attacks’ are very frequent or severe, some centrestreat this lymphoma with low doses of methotrexate.Rarer cutaneous T-cell lymphomasSubcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a slow-growinglymphoma that can occur at any age. It is slightly more common in women than it isin men. It starts in the fatty layer of the skin, just below the surface, and shows upas one or more plaques or nodules, often on the legs. Some people will have othermore general symptoms and signs, such as fevers, low blood counts and weightloss. SPTCL is often treated successfully with steroid tablets. If additional treatmentis required, local radiotherapy or chemotherapy with doxorubicin can be used.Combination chemotherapy (eg with CHOP) or even a stem cell transplant might beconsidered if SPTCL is behaving in a more aggressive way.Primary cutaneous CD4-positive small/medium T-cell lymphoma usually appearsas a single plaque or nodule on the face, neck or upper trunk. It is a slow-growinglymphoma with a good outlook. The plaque or nodule is usually removed surgically ortreated with radiotherapy. If the lymphoma is more widespread, cyclophosphamide orinterferon alpha might be suggested as treatment.Primary cutaneous gamma/delta T-cell lymphoma is a faster growing type of skinlymphoma that usually shows up as patches and plaques, most commonly on thearms or legs. It usually occurs in adults. Many people with this lymphoma experiencenight sweats, fevers and weight loss. Sometimes the blood counts are low and theliver and spleen can become enlarged.Primary cutaneous CD8-positive aggressive epidermitropic cytotoxic T-celllymphoma is another faster growing lymphoma. It occurs mainly in adults. It appearsas widespread papules and plaques and tumours on the skin, which can ulcerate. Itcan also affect the lining of the mouth.These last two skin lymphomas are often treated using a combination of chemotherapydrugs and sometimes a stem cell transplant is considered.There is more information on these treatments in the article, ‘Treatments forskin lymphoma’. We also have information on stem cell transplants. Please callthe helpline if you would like to receive this information (0808 808 5555) ordownload it from our website (www.lymphomas.org.uk).Cutaneous T-cell lymphomaLYM0157/CTCL/2013v314/18
Taking part in a clinical trialResearchers are continually trying to find out which treatment or combination oftreatments work best for lymphomas. You might be asked to take part in a clinicalresearch trial. Clinical trials are very important because they allow new treatments tobe evaluated and compared with more established ones. Studying treatments like thisis the only way that new and hopefully better treatments can become available. Whenyou are enrolled into a clinical trial you can be assured that you will receive modernand appropriate treatments.There are advantages to taking part in a clinical trial and it is always worth asking yourconsultant if there might be a trial you could take part in. A major advantage is thatsome of the newer treatments are only available if you are in a clinical trial.You don’t have to take part in a trial if you are offered this, however. If you don’t feelcomfortable with the idea of taking part in a trial after discussing all the optionswith your medical team be assured that you will receive the best current standardtreatment available.We have booklet about taking part in clinical trials. If you would like a copy of thisor if you would like to talk to someone about entering a trial please phone thehelpline (0808 808 5555). The booklet can also be downloaded from our website(www.lymphomas.org.uk).Going for hospital check-upsHow often you attend the clinic for check-ups will depend on what kind of lymphomayou have, the stage it is assessed to be at and how it is responding to treatment. Ifyou have a slow-growing lymphoma at an early stage and it is being observed, or if itis stable or in remission after treatment you would probably only be seen every 6 to12 months. This would probably be your experience if you have mycosis fungoides.If your lymphoma is a faster growing type or is continuing to grow (progressing) youmight be seen as often as every 4 to 6 weeks.At the clinic you will be asked about your symptoms and you will be examined.Always let the medical team know if there are any symptoms that have been troublingyou or about any changes in your skin or new swellings that have developed. Youwould only occasionally need blood tests, scans or further biopsies at these visits.You might like to read our other information sheets on skin lymphomas,‘Treatments for skin lymphomas’ and ‘Living with skin lymphoma’, whichdescribes ways of coping with the symptoms and other day-to-day practicalitiesof having skin lymphoma. If you would like these or if you have any concernsthat you would like to discuss, please phone our helpline (0808 808 5555).This information is also available on our website (www.lymphomas.org.uk).Cutaneous T-cell lymphomaLYM0157/CTCL/2013v315/18
Page 1 and 2: Freephone helpline 0808 808 5555inf
Page 3: What causes skin lymphoma?The cause
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Page 8 and 9: What do the ‘stages’ mean?The s
Page 10 and 11: Some slow-growing lymphomas do not
Page 12 and 13: Erythroderma can be treated by extr
Page 16 and 17: AcknowledgementsWe are very gratefu
Page 18: Willemze R, et al. WHO-EORTC classi

Cutaneous T-cell lymphoma - Lymphoma Association

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