Cutaneous T-cell Lymphomas

Lymphomas (see also Overview of Lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. These... read more ) are cancers of a specific type of white blood cells known as lymphocytes Acquired Immunity One of the body's lines of defense ( immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more . These cells help fight infections. Lymphomas can develop from either B or T lymphocytes, the two main types of lymphocyte. T lymphocytes are important in regulating the immune system and in fighting viral infections. B lymphocytes produce antibodies Antibodies One of the body's lines of defense ( immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more , which are essential in fighting off some infections.

The most common types of CTCL are

Most people who develop CTCL are older than 50. It originates from mature T cells (T lymphocytes) and first affects the skin.

Mycosis fungoides starts so subtly and grows so slowly that it may not be noticed initially. It causes a long-lasting, itchy rash—sometimes a small area of thickened, itchy skin that later develops nodules and slowly spreads. In some people, it develops into a form of leukemia (Sézary syndrome). In other people, it progresses to the lymph nodes and internal organs. Even with a biopsy, doctors have trouble diagnosing this disease in its early stages. However, later in the course of the disease, a biopsy shows lymphoma cells in the skin.

Sézary syndrome also starts subtly and grows slowly. It causes the skin to become red all over the body with cracking of the palms and soles. Lymph node enlargement is usually mild. In addition to the rash, people may also have symptoms of fever, night sweats, and weight loss. As with mycosis fungoides, doctors have trouble diagnosing this disease in its early stage even with a skin biopsy. A blood smear (where a drop of blood is examined under a microscope) may show Sézary cells (malignant T cells with a characteristic appearance) and this can help make the diagnosis in addition to a skin biopsy.

Treatment of CTCL can be divided into

Therapy directed at the skin is usually started first and is often effective for years. This type of treatment includes medicated creams such as corticosteroids or retinoids applied to the skin, or a form of radiation therapy called electron beam therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more or with sunlight (phototherapy Phototherapy Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune... read more ).

Chemotherapy Chemotherapy and Other Systemic Cancer Treatments Systemic treatments are those that have effects throughout the body rather than being applied directly to the cancer. Chemotherapy is a form of systemic treatment that uses drugs to kill cancer... read more is given if skin-directed therapy has failed or in people with CTCL that has spread beyond the skin.