Cutaneous T-cell Lymphoma

P1, N=20, Suspended, H. Lee Moffitt Cancer Center and Research Institute | Recruiting --> Suspended

A trial of flucloxacillin produced no improvement, and an urgent ultrasound revealed nonspecific skin thickening, prompting a skin biopsy...In this case, the absence of systemic involvement on imaging and the atypical immuno-phenotypic features underscore the complexity of distinguishing between tumour-stage MF and PCGDTCL. This case highlights the role of detailed histopathological evaluation of rare cutaneous lymphomas and emphasizes the need for a multidisciplinary approach to design both local and systemic treatment strategies for individual patients.

Treatment with gemcitabine and oxaliplatin chemotherapy showed significant improvement, complemented by radiotherapy for refractory lesions. Histopathological evaluation and EBV testing are critical for differentiation from other conditions. While initial responses to chemoradiotherapy are promising, recurrence remains common, highlighting the need for vigilant follow-up and optimized therapeutic strategies.

He commenced first-line systemic therapy with methotrexate, but had no response. He was switched to brentuximab vedotin and has received eight cycles with partial response...Approach to mycosis fungoides in children: consensus-based recommendations. J Am Acad Dermatol 2024; 91: 1078-85).

He had tried superpotent topical corticosteroids and oral prednisolone, as well as emollients, none of which had improved his symptoms...Tralokinumab was trialled for 12 weeks, as this has a single therapeutic target (interleukin-13), but unfortunately there was no improvement. Following discussion with the immunologists, he was commenced on upadacitinib as this was felt to have a more targeted immunosuppressive effect above agents such as methotrexate and dupilumab. We await his next follow-up appointment to assess response. This case highlights the complexity of treating an immunocompromised individual with immunosuppressive agents, when the cause of their immunosuppression is unknown.

While topical corticosteroids are the most common treatment adopted, other options include watchful waiting, phototherapy and systemic methotrexate...Clinicians should remain vigilant in diagnosing LyP. Although its course is often benign, the association with haematological malignancy requires both careful clinicopathological correlation for diagnosis and long-term follow-up.

Despite aggressive therapy, the patient died 21 months after diagnosis. This case delineates the importance of early biopsy, integration of molecular studies, and the urgent need for therapies to improve outcomes in this aggressive lymphoma.

P1, N=43, Active, not recruiting, UNC Lineberger Comprehensive Cancer Center | Recruiting --> Active, not recruiting | Trial completion date: Sep 2041 --> Nov 2039 | Trial primary completion date: Sep 2026 --> Dec 2025

This case adds to the spectrum of SPTCL presentations, emphasizing the importance of considering SPTCL in panniculitis-like lesions refractory to conventional treatment. Prompt histopathological evaluation with immunophenotyping is crucial for early diagnosis and appropriate management to improve patient outcomes.

These findings suggest the follicular microenvironment may provide survival advantages to malignant T cells while promoting a dysregulated anti-tumor immune response. These observations provide insight into the mechanisms underlying the more aggressive clinical features of FMF versus CMF.

P1/2, N=38, Active, not recruiting, UNC Lineberger Comprehensive Cancer Center | Recruiting --> Active, not recruiting | Trial completion date: Aug 2038 --> Nov 2039 | Trial primary completion date: Sep 2027 --> Dec 2025

However, the patient relapsed within a few months and needed to be treated with methotrexate. This example highlights the importance of careful clinical, histological, and immunohistochemical testing for timely HMF detection as well as the need for vigilant monitoring to effectively manage recurrences.