New Research Could Change Cutaneous Lymphoma Treatment
Though new research, led by Dr. Pedro Quaglino from the University of Turin Medical School in Italy, is far from finished, the team has already discovered some interesting data trends.
Cutaneous lymphoma is a relatively rare disease, accounting for approximately 4 percent of non-Hodgkin lymphoma cases. Mycosis fungoides is the most common type, affecting about 1 in 100,000 people worldwide. Because of its rarity, doctors don’t know enough about this disease to best manage it. The disease usually strikes people during their mid-fifties and is very rare in children. However, it is possible for cutaneous lymphoma to affect a person at any age.
This challenge was attempted to tackle by Dr Pedro Quaglino. He conducted a study termed early stage Prospective cutaenous lymphoma international prognostic index trial. He observed that in the long run how different treatment for early fungoides helped. He did this by collecting data in 14 different countries from 42 centres. Their main goal was to identify factors that could affect the disease prognosis and improve the quality of life. They analyzed the data for two years. The tracked 472 patients and found that mycosis fungoides was present in 80.7 percent and folliculotropic type was present in 15.7 percent. They also noted as with an increased age there was an increase in the disease stage. Very few were female. They would like to study for more five years.
Catching the disease early is the best way. Typically after diagnosis a survival of 35 years is expected if the diagnosis is between stage 1A and II A. Till this stage there are no cancer cells inside the lymph node. A more advanced stage can be reached by 25percent of these who are in early stage. After which the median survival is of 4 years.
Only skin is involved in early stage lymphoma, thus superficially the disease is limited. The skin becomes patchy. There are no signs of tumor. The life expectancy of patients becomes one year once the lymphoma has spread to lymph nodes. The treatment options in the earlier stage are quite effective. Mostly skin directed therapies are chosen by the doctor. This can be done individually as well as in combination. In early stages both have some favourable responses. They can potentially stop the disease in its track by slowing the progression of the disease.
In fewer patients developing a good treatment is the biggest challenge. Some may benefit from individualized therapies and there is no way to tell which one is better. More study is required to know what characteristics are present in a patient and how treatment responses are affected by these. It will take another 8 years to do analysis of study. Hence how effective the treatments are no such conclusions have been drawn. Based on the personal preference of the patient selection is done. Currently wide range of treatment is available. Emollients and topical steroids are some of the topical treatments. UV light therapies include phototherapy and extracorporeal photophoresis, gemcitabine and local radiotherapy are some classic cancer treatment that may be considered. Another potential treatment is watchful waiting. Some systemic therapies are also used. Less often used treatment but included in the study are electron-beam therapy and topical nitrogen mustard.
In the study it was found that 71 people in their early stage did not develop disease progression. The team has already discovered some interesting data trends such as diagnosis. People noted that a poor prognostic factor could be advanced age. However this may not be the case since more commonly advanced disease is found in the elderly. It was noted that early diagnosis would occur in younger.
It was found that phototherapy, topical steroids and psoralen were commonly prescribed. Also it was found that highest rate of treatment response was in phototherapy. Also it was said that many factors could influence treatment response rate. Many patients are not aware of the disease since it looks similar to psoriasis and eczema. Prognosis is affected by delayed diagnosis. To choose the best first- line treatment researchers hope to find an insight. For longer period of time patients need to be studies. Since under certain circumstances the treatment response is better hence experts recommend that dermatologist work hard to tray and diagnose the disease early.