作者投稿
专家审稿
编辑办公
主编办公
中国蕈样肉芽肿诊疗及管理专家指南
doi: 10.12376/j.issn.2097-0501.2023.02.008
通信作者：刘洁, E-mail：Liujie04672@pumch.cn 晋红中, E-mail：jinhongzhong@263.net
Expert Guidelines for the Diagnosis, Treatment, and Management of Mycosis Fungoides in China
Corresponding authors: LIU Jie, E-mail: Liujie04672@pumch.cn JIN Hongzhong, E-mail: jinhongzhong@263.net
-
摘要: 蕈样肉芽肿(MF)是原发于记忆性辅助T细胞的皮肤淋巴瘤。典型的MF皮损具有典型的3期表现，早期为斑片，逐渐形成浸润性斑块，晚期可出现肿瘤、红皮病，也可能累及淋巴结和其他脏器，自然病程可达数十年。MF早期诊断困难，需要定期随访、重复活检，并结合临床表现、组织病理、免疫表型、分子生物学进行综合判断。MF患者的治疗应根据分期决定，早期MF可选择外用药物、光疗、放疗等皮肤定向治疗，晚期MF或复发难治性早期MF需进行系统治疗，系统治疗均可联合皮肤定向治疗以缓解症状。多学科诊疗模式对于MF患者的管理十分重要，在制订治疗方案时应由多学科诊疗团队对患者进行整体评估，充分权衡可能的获益、患者耐受性及治疗副反应，以延缓疾病进展，改善患者生活质量。本指南参考国外国内的最新研究成果，结合中国的实际情况和专家经验制定，旨在规范中国MF的诊断、治疗与管理流程。Abstract: Mycosis fungoides (MF) is a cutaneous lymphoma originating from memory helper T cells. The lesion caused by classical type of MF is characterized by the progression from patches at early stages, advancing to more infiltrated plaques and eventually to tumors or erythroderma. Lymph nodes and visceral organs may be involved. The clinical course can last for decades. Early diagnosis of MF is difficult, usually requiring regular follow-up, repeated skin biopsy, and comprehensive analysis of the clinical manifestations, and involving histopathology, immunophenotype, and molecular biology. The treatment of MF should be determined on the stage of the disease. Patients with early-stage MF should be treated with skin-directed therapy, such as topical drugs, phototherapy, and radiotherapy. Advanced-stage MF or recurrent and refractory early-stage MF needs systemic treatments which can be combined with skin-directed treatment to alleviate symptoms. Multidisciplinary treatment (MDT) model is important for the management of patients with MF. The MDT team should conduct an overall evaluation of the patients when formulating the treatment plan, fully weighing the possible benefits, patient tolerance and side effects of treatment, so as to delay the progress of the disease and improve the quality of life of patients. With reference to the latest international and national research data, combined with the true state of China and expert experience, we developed the guidelines to standardize the process of diagnosis, treatment, and management of MF in China.
-
Key words:
- mycosis fungoides /
- diagnosis /
- treatment /
- management /
- guidelines
-
图 1 MF治疗方案
“ ”所指方格表示该阶段治疗可选择的药物种类，方格从上至下表示优先级别依次递减；“”所指方格表示一线治疗效果不佳时可选择的二线治疗方案; SDT: 皮肤定向治疗; PUVA: 补骨脂素光化学疗法；NB-UVB: 窄谱中波紫外线；TSEBT: 全身皮肤电子束治疗；HDACi: 组蛋白去乙酰化酶抑制剂；ECP: 体外光分离疗法
Figure 1. Treatment protocols of MF
表 1 早期蕈样肉芽肿(MF)诊断标准*
Table 1. Algorithm for diagnosis of early mycosis fungoides(MF)
标准 评分标准 临床特征 主要标准：
存在持续性和/或进行性的斑片和斑块
次要标准：
·非暴露部位的病变
·病变的大小、形状各异
·皮肤异色症符合主要标准
·同时符合1项次要标准1分
·同时符合2项或3项次要标准2分组织病理学 主要标准：
浅表淋巴细胞浸润
次要标准：
·不伴海绵形成的亲表皮现象
·淋巴细胞异型性符合主要标准
·同时符合1项次要标准1分
·同时符合2项次要标准2分分子生物学 克隆性TCR基因重排 基因重排阳性1分 免疫病理学 ·少于50%的T细胞表达CD2、CD3或CD5
·少于10%的T细胞表达CD7
·表皮细胞和真皮细胞在CD2、CD3、CD5或CD7的表达上存在不一致满足任意1项或以上者1分 *转载已获许可，©2005 American Academy of Dermatology, Inc. 
下载: 导出CSV
表 2 改良的严重程度加权评估工具(mSWAT)*
Table 2. Modified Severity Weighted Assessment Tool(mSWAT)
部位 体表面积(%BSA) 皮损类型 斑片1 斑块2 肿瘤3 头 7 颈 2 躯干前部 13 上臂 8 前臂 6 手 5 躯干后部 13 臀部 5 大腿 19 小腿 14 足 7 腹股沟 1 皮损总体表面积 权重因子 ×1 ×2 ×4 皮损总体表面积×权重因子 mSWAT评分为各类型皮损得分总和；1斑片指任何大小的无浸润或非隆起性皮损，可能出现皮肤异色样改变；2斑块指任何大小的隆起或浸润性皮损，可能出现结痂、溃疡或皮肤异色样改变；3肿瘤指直径≥1 cm的实性或结节样皮损，且有证据证明皮损浸润程度较深和/或垂直生长; *转载已获许可，©2011 American Society of Clinical Oncology
下载: 导出CSV
表 3 MF的TNMB分期*
Table 3. TNMB classification of MF
分期 临床特征 皮肤(T) T1 局限斑片，丘疹，和/或斑块，累及＜10%体表面积，可以进一步分为T1a(仅有斑片)和T1b(斑块±斑片) T2 斑片，丘疹，和/或斑块，累及≥10%体表面积，可以进一步分为T2a(仅有斑片)和T2b(斑块±斑片) T3 一个或一个以上肿瘤(直径≥1 cm) T4 红斑融合，累及≥80%体表面积 淋巴结(N) N0 无临床异常的外周淋巴结，无需活检 N1 临床异常外周淋巴结，组织病理Dutch分级1或NCI LN0~2 N1a 克隆阴性 N1b 克隆阳性 N2 临床异常外周淋巴结，组织病理Dutch分级2或NCI LN3 N2a 克隆阴性 N2b 克隆阳性 N3 临床异常外周淋巴结，组织病理Dutch分级3~4或NCI LN4，克隆阴性或阳性 NX 临床异常外周淋巴结，无组织病理证据 内脏(M) M0 无内脏受累 M1 内脏受累(必须由组织病理确诊，并且器官受累必须是特异性的) 血液(B) B0 无明显血液受累：外周血中Sézary细胞≤5% B0a 克隆阴性 B0b 克隆阳性 B1 低血液肿瘤负荷，外周血中Sézary细胞＞5%，但不满足B2的标准 B1a 克隆阴性 B1b 克隆阳性 B2 高血液肿瘤负荷：克隆阳性且满足以下一项：Sézary细胞≥1000/μL；CD4/CD8≥10；CD4+CD7－细胞≥40%或CD4+CD26－细胞≥30% *转载已获许可，©2007 American Society of Hematology
下载: 导出CSV
表 4 MF临床分期系统*
Table 4. Clinical staging of MF
临床分期 皮肤(T) 淋巴结(N) 内脏(M) 血液(B) ⅠA 1 0 0 0，1 ⅠB 2 0 0 0，1 ⅡA 1，2 1，2 0 0，1 ⅡB 3 0~2 0 0，1 ⅢA 4 0~2 0 0 ⅢB 4 0~2 0 1 ⅣA1 1~4 0~2 0 2 ⅣA2 1~4 3 0 0~2 ⅣB 1~4 0~3 1 0~2 *转载已获许可，©2007 American Society of Hematology
下载: 导出CSV
表 5 MF淋巴结组织病理分期*
Table 5. Histopathologic staging of lymph nodes in MF
ISCL/EORTC分期 Dutch分级 NCI-VA分期 N1 1级：皮病性淋巴结炎 LN0：无异型淋巴细胞
LN1：偶见或散在异型淋巴细胞(非簇集分布)
LN2：多数异型淋巴细胞或呈3~6个细胞簇N2 2级：皮病性淋巴结炎；MF早期累及(存在脑回样核＞7.5 μm) LN3：淋巴细胞聚集，淋巴结结构保留 N3 3级：淋巴结结构部分破坏；多数异型性脑回状单一核细胞 LN4：异型淋巴细胞或肿瘤细胞部分或完全破坏淋巴结结构 4级：完全破坏淋巴结结构 *转载已获许可，©2007 American Society of Hematology
下载: 导出CSV
表 6 证据等级(牛津循证医学中心2011版)
Table 6. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence
证据等级 描述 证据等级1 随机试验或n-of-1试验的系统综述 证据等级2 随机试验或效果显著的观察性研究 证据等级3 非随机对照队列或随访研究 证据等级4 病例系列、病例对照研究或历史对照研究 证据等级5 基于机制的推断
下载: 导出CSV
表 7 Fitzpatrick皮肤类型与推荐窄谱中波紫外线(NB-UVB)剂量*
Table 7. Treatment recommendations for dose of narrow band ultraviolet B(NB-UVB) based on Fitzpatrick skin type
皮肤类型 起始剂量(mJ/cm2) 增加剂量(mJ/cm2) Ⅰ 130 15 Ⅱ 220 25 Ⅲ 260 40 Ⅳ 330 45 Ⅴ 350 60 Ⅵ 400 65 *转载已获许可，©2015 American Academy of Dermatology, Inc.
下载: 导出CSV
表 8 Fitzpatrick皮肤类型与推荐补骨脂素光化学疗法(PUVA)剂量*
Table 8. Treatment recommendations for dose of psoralen ultraviolet A (PUVA) based on Fitzpatrick skin type
皮肤类型 起始剂量(J/cm2) 增加剂量(J/cm2) Ⅰ 0.5 0.5 Ⅱ 1.0 0.5 Ⅲ 1.5 1.0 Ⅳ 2.0 1.0 Ⅴ 2.5 1.5 Ⅵ 3.0 1.5 *转载已获许可，©2015 American Academy of Dermatology, Inc.
下载: 导出CSV
表 9 MF总体反应评价标准*
Table 9. Global response score of MF
总体反应 皮肤 淋巴结 内脏 血液 CR CR 均为CR或无受累(noninvolved，NI) PR CR 均无CR/NI，且均无PD PR 均无PD，如基线存在受累，至少一项为CR或PR SD PR 均无PD，如基线存在受累，均无CR或PR SD 各项为CR/NI、PR、SD，均无PD PD 任何一项为PD 复发 任何一项为复发 *转载已获许可，©2011 American Society of Clinical Oncology
下载: 导出CSV
-
[1] Willemze R, Cerroni L, Kempf W, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas[J]. Blood, 2019, 133(16): 1703-1714. doi: 10.1182/blood-2018-11-881268 [2] Willemze R, Hodak E, Zinzani PL, et al. ESMO Guidelines Committee. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2018, 29(Suppl 4): iv30-iv40. [3] Maguire A, Puelles J, Raboisson P, et al. Early-stage mycosis fungoides: epidemiology and prognosis[J]. Acta Derm Venereol, 2020, 100(1): adv00013. [4] Bradford PT, Devesa SS, Anderson WF, et al. Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases[J]. Blood, 2009, 113(21): 5064-5073. doi: 10.1182/blood-2008-10-184168 [5] Imam MH, Shenoy PJ, Flowers CR, et al. Incidence and survival patterns of cutaneous T-cell lymphomas in the United States[J]. Leuk Lymphoma, 2013, 54(4): 752-759. doi: 10.3109/10428194.2012.729831 [6] Gilson D, Whittaker SJ, Child FJ, et al. British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018[J]. Br J Dermatol, 2019, 180(3): 496-526. doi: 10.1111/bjd.17240 [7] Tan ES, Tang MB, Tan SH. Retrospective 5-year review of 131 patients with mycosis fungoides and Sézary syndrome seen at the National Skin Centre, Singapore[J]. Australas J Dermatol, 2006, 47(4): 248-252. doi: 10.1111/j.1440-0960.2006.00290.x [8] Luo Y, Liu Z, Liu J, et al. Mycosis fungoides and variants of mycosis fungoides: a retrospective study of 93 patients in a Chinese population at a single center[J]. Ann Dermatol, 2020, 32(1): 14-20. doi: 10.5021/ad.2020.32.1.14 [9] Liu J, Yu X, Liu Y, et al. Relative frequency and survival of primary cutaneous lymphomas: a retrospective analysis of 98 patients[J]. Chin Med J (Engl), 2014, 127(4): 645-650. [10] Wilcox RA. Cutaneous T-cell lymphoma: 2016 update on diagnosis, risk-stratification, and management[J]. Am J Hematol, 2016, 91(1): 151-165. doi: 10.1002/ajh.24233 [11] McGirt LY, Jia P, Baerenwald DA, et al. Whole-genome sequencing reveals oncogenic mutations in mycosis fungoides[J]. Blood, 2015, 126(4): 508-519. doi: 10.1182/blood-2014-11-611194 [12] Aschebrook-Kilfoy B, Cocco P, La Vecchia C, et al. Medical history, lifestyle, family history, and occupational risk factors for mycosis fungoides and Sézary syndrome: the InterLymph Non-Hodgkin Lymphoma Subtypes Project[J]. J Natl Cancer Inst Monogr, 2014, 2014(48): 98-105. doi: 10.1093/jncimonographs/lgu008 [13] Li G, Vowels BR, Benoit BM, et al. Failure to detect human T-lymphotropic virus type-Ⅰ proviral DNA in cell lines and tissues from patients with cutaneous T-cell lymphoma[J]. J Invest Dermatol, 1996, 107: 308-313. doi: 10.1111/1523-1747.ep12363017 [14] Krejsgaard T, Lindahl LM, Mongan NP, et al. Malignant inflammation in cutaneous T-cell lymphoma-a hostile take-over[J]. Semin Immunopathol, 2017, 39(3): 269-282. doi: 10.1007/s00281-016-0594-9 [15] Pimpinelli N, Olsen EA, Santucci M, et al. Defining early mycosis fungoides[J]. J Am Acad Dermatol, 2005, 53(6): 1053-1063. doi: 10.1016/j.jaad.2005.08.057 [16] Cerroni L. Skin lymphoma: the Illustrated Guide, 5th Edition[M]. Hoboken, NJ: John Wiley & Sons, 2020: 15-81. [17] Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)[J]. Blood, 2007, 110(6): 1713-1722. doi: 10.1182/blood-2007-03-055749 [18] National Comprehensive Cancer Network. NCCN Guidelines: primary cutaneous lymphomas (2022 Version 1)[DB/OL]. (2022-01-26)[2022-05-18]. http://www.nccn.org .[19] Elder DE, Massi D, Scolyer R, et al. WHO Classification of Skin Tumours[M]. 4th edition. Lyon: International Agency for Research on Cancer, 2018: 226-233. [20] Benner MF, Jansen PM, Vermeer MH, et al. Prognostic factors in transformed mycosis fungoides: a retrospective analysis of 100 cases[J]. Blood, 2012, 119(7): 1643-1649. doi: 10.1182/blood-2011-08-376319 [21] Haun PL, Scarisbrick JJ. Fast facts: cutaneous T-cell Lymphoma[M]. Oxford: Karger, 2019. [22] Xu C, Liu J, Wang T, et al. Dermoscopic patterns of early-stage mycosis fungoides in a Chinese population[J]. Clin Exp Dermatol, 2019, 44(2): 169-175. doi: 10.1111/ced.13680 [23] Errichetti E, Apalla Z, Geller S, et al. Dermoscopic spectrum of mycosis fungoides: a retrospective observational study by the International Dermoscopy Society[J]. J Eur Acad Dermatol Venereol, 2022, 36(7): 1045-1053. doi: 10.1111/jdv.18078 [24] Agero AL, Gill M, Ardigo M, et al. In vivo reflectance confocal microscopy of mycosis fungoides: a preliminary study[J]. J Am Acad Dermatol, 2007, 57(3): 435-441. doi: 10.1016/j.jaad.2007.02.026 [25] Fujii K, Kanekura T. Next-generation sequencing technolo-gies for early-stage cutaneous T-cell lymphoma[J]. Front Med (Lausanne), 2019, 6: 181. [26] Rea B, Haun P, Emerson R, et al. Role of high-throughput sequencing in the diagnosis of cutaneous T-cell lymphoma[J]. J Clin Pathol, 2018, 71(9): 814-820. doi: 10.1136/jclinpath-2018-205004 [27] Zhang Y, Wang Y, Yu R, et al. Molecular markers of early-stage mycosis fungoides[J]. J Invest Dermatol, 2012, 132(6): 1698-1706. doi: 10.1038/jid.2012.13 [28] Dulmage B, Geskin L, Guitart J, et al. The biomarker landscape in mycosis fungoides and Sézary syndrome[J]. Exp Dermatol, 2017, 26(8): 668-676. doi: 10.1111/exd.13261 [29] Leng L, Liu Z, Ma J, et al. Proteomic identification of new diagnostic biomarkers of early-stage cutaneous mycosis fungoides[J]. Cancer Commun (Lond), 2022, 42(6): 558-562. doi: 10.1002/cac2.12266 [30] Litvinov IV, Netchiporouk E, Cordeiro B, et al. The use of transcriptional profiling to improve personalized diagnosis and management of cutaneous T-cell lymphoma (CTCL)[J]. Clin Cancer Res, 2015, 21(12): 2820-2829. doi: 10.1158/1078-0432.CCR-14-3322 [31] Wen P, Xie Y, Wang L. The role of microRNA in pathogenesis, diagnosis, different variants, treatment and prognosis of mycosis fungoides[J]. Front Oncol, 2021, 11: 752817. doi: 10.3389/fonc.2021.752817 [32] Xu C, Zhou D, Luo Y, et al. Tissue and serum lipidome shows altered lipid composition with diagnostic potential in mycosis fungoides[J]. Oncotarget, 2017, 8(29): 48041-48050. doi: 10.18632/oncotarget.18228 [33] Chairatchaneeboon M, Thanomkitti K, Kim EJ. Parapsoriasis-a diagnosis with an identity crisis: a narrative review[J]. Dermatol Ther (Heidelb), 2022, 12(5): 1091-1102. doi: 10.1007/s13555-022-00716-y [34] Olsen EA, Whittaker S, Kim YH, et al. Clinical end points and response criteria in mycosis fungoides and Sézary syndrome: a consensus statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer[J]. J Clin Oncol, 2011, 29(18): 2598-2607. doi: 10.1200/JCO.2010.32.0630 [35] Zackheim HS. Treatment of patch-stage mycosis fungoides with topical corticosteroids[J]. Dermatol Ther, 2003, 16(4): 283-287. doi: 10.1111/j.1396-0296.2003.01639.x [36] Kartan S, Shalabi D, O'Donnell M, et al. Response to topical corticosteroid monotherapy in mycosis fungoides[J]. J Am Acad Dermatol, 2021, 84(3): 615-623. doi: 10.1016/j.jaad.2020.05.043 [37] Kim YH, Martinez G, Varghese A, et al. Topical nitrogen mustard in the management of mycosis fungoides: update of the Stanford experience[J]. Arch Dermatol, 2003, 139(2): 165-173. [38] Garcia-Saleem TJ, Stonesifer CJ, Khaleel AE, et al. Management of mycosis fungoides with topical chlormethine/mechlorethamine gel: a Columbia University cutaneous lymphoma center experience[J]. Acta Derm Venereol, 2021, 101(9): adv00544. doi: 10.2340/00015555-3911 [39] Zackheim HS. Topical carmustine (BCNU) in the treatment of mycosis fungoides[J]. Dermatol Ther, 2003, 16(4): 299-302. doi: 10.1111/j.1396-0296.2003.01641.x [40] Zackheim HS, Epstein EH, Crain WR. Topical carmustine (BCNU) for cutaneous T cell lymphoma: a 15-year experience in 143 patients[J]. J Am Acad Dermatol, 1990, 22(5 Pt 1): 802-810. [41] Breneman D, Duvic M, Kuzel T, et al. Phase 1 and 2 trial of bexarotene gel for skin-directed treatment of patients with cutaneous T-cell lymphoma[J]. Arch Dermatol, 2002, 138(3): 325-332. [42] Heald P, Mehlmauer M, Martin AG, et al. Topical bexarotene therapy for patients with refractory or persistent early-stage cutaneous T-cell lymphoma: results of the phase Ⅲ clinical trial[J]. J Am Acad Dermatol, 2003, 49(5): 801-815. doi: 10.1016/S0190-9622(03)01475-0 [43] Apisarnthanarax N, Talpur R, Ward S, et al. Tazarotene 0.1% gel for refractory mycosis fungoides lesions: an open-label pilot study[J]. J Am Acad Dermatol, 2004, 50(4): 600-607. doi: 10.1016/j.jaad.2003.09.005 [44] Deeths MJ, Chapman JT, Dellavalle RP, et al. Treatment of patch and plaque stage mycosis fungoides with imiquimod 5% cream[J]. J Am Acad Dermatol, 2005, 52(2): 275-280. doi: 10.1016/j.jaad.2004.04.049 [45] 韩大伟, 王涛, 刘洁, 等. 紫外线照射治疗蕈样肉芽肿的不良反应观察[J]. 临床皮肤科杂志, 2017, 46(10): 721-724. doi: 10.16761/j.cnki.1000-4963.2017.10.017 [46] Olsen EA, Hodak E, Anderson T, et al. Guidelines for phototherapy of mycosis fungoides and Sézary syndrome: a consensus statement of the United States Cutaneous Lymphoma Consortium[J]. J Am Acad Dermatol, 2016, 74(1): 27-58. doi: 10.1016/j.jaad.2015.09.033 [47] Trautinger F, Eder J, Assaf C, et al. European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome-Update 2017[J]. Eur J Cancer, 2017, 77: 57-74. doi: 10.1016/j.ejca.2017.02.027 [48] Boztepe G, Sahin S, Ayhan M, et al. Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides[J]. J Am Acad Dermatol, 2005, 53(2): 242-246. doi: 10.1016/j.jaad.2005.03.012 [49] Specht L, Dabaja B, Illidge T, et al. International Lymphoma Radiation Oncology Group. Modern radiation therapy for primary cutaneous lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group[J]. Int J Radiat Oncol Biol Phys, 2015, 92(1): 32-39. doi: 10.1016/j.ijrobp.2015.01.008 [50] Wilson LD, Kacinski BM, Jones GW. Local superficial radiotherapy in the management of minimal stage IA cutaneous T-cell lymphoma (Mycosis Fungoides)[J]. Int J Radiat Oncol Biol Phys, 1998, 40(1): 109-115. doi: 10.1016/S0360-3016(97)00553-1 [51] Micaily B, Miyamoto C, Kantor G, et al. Radiotherapy for unilesional mycosis fungoides[J]. Int J Radiat Oncol Biol Phys, 1998, 42(2): 361-364. doi: 10.1016/S0360-3016(98)00218-1 [52] Xu CC, Zhang T, Wang T, et al. Palliative local radiotherapy in the treatment of tumor-stage cutaneous T-cell lymphoma/mycosis fungoides[J]. Chin Med Sci J, 2014, 29(1): 33-37. doi: 10.1016/S1001-9294(14)60021-3 [53] Olsen EA. Interferon in the treatment of cutaneous T-cell lymphoma[J]. Dermatol Ther, 2003, 16(4): 311-321. doi: 10.1111/j.1396-0296.2003.01643.x [54] Chiarion-Sileni V, Bononi A, Fornasa CV, et al. PhaseⅡ trial of interferon-a-2a plus psolaren with ultraviolet light A in patients with cutaneous T-cell lymphoma[J]. Cancer, 2002, 95(3): 569-575. doi: 10.1002/cncr.10706 [55] Duvic M, Martin AG, Kim Y, et al. Phase 2 and 3 clinical trial of oral bexarotene (Targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma[J]. Arch Dermatol, 2001, 137(5): 581-593. [56] Olsen EA, Kim YH, Kuzel TM, et al. Phase Ⅱb multicenter trial of vorinostat in patients with persistent, progressive, or treatment refractory cutaneous T-cell lymphoma[J]. J Clin Oncol, 2007, 25(21): 3109-3115. doi: 10.1200/JCO.2006.10.2434 [57] Whittaker SJ, Demierre MF, Kim EJ, et al. Final results from a multicenter, international, pivotal study of romidepsin in refractory cutaneous T-cell lymphoma[J]. J Clin Oncol, 2010, 28(29): 4485-4491. doi: 10.1200/JCO.2010.28.9066 [58] Che Y, Ding X, Song J, et al. Effective remission of chidamide on treatment of advanced mycosis fungoides: an unusual case report[J]. Dermatol Ther, 2019, 32(4): e12944. [59] Prince HM, Kim YH, Horwitz SM, et al. Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial[J]. Lancet, 2017, 390(10094): 555-566. doi: 10.1016/S0140-6736(17)31266-7 [60] Duvic M, Pinter-Brown LC, Foss FM, et al. Phase 1/2 study of mogamulizumab, a defucosylated anti-CCR4 antibody, in previously treated patients with cutaneous T-cell lymphoma[J]. Blood, 2015, 125(12): 1883-1889. doi: 10.1182/blood-2014-09-600924 [61] Kim YH, Bagot M, Pinter-Brown L, et al. Mogamuli-zumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial[J]. Lancet Oncol, 2018, 19(9): 1192-1204. doi: 10.1016/S1470-2045(18)30379-6 [62] Prince HM, Duvic M, Martin A, et al. Phase Ⅲ placebo-controlled trial of denileukin diftitox for patients with cutaneous T cell lymphoma[J]. J Clin Oncol, 2010, 28(11): 1870-1877. doi: 10.1200/JCO.2009.26.2386 [63] Lundin J, Hagberg H, Repp R, et al. Phase 2 study of alemtuzumab (anti CD52 monoclonal antibody) in patients with advanced mycosis fungoides/Sézary syndrome[J]. Blood, 2003, 101(11): 4267-4272. doi: 10.1182/blood-2002-09-2802 [64] de Masson A, Guitera P, Brice P, et al. Long-term efficacy and safety of alemtuzumab in advanced primary cutaneous T cell lymphomas[J]. Br J Dermatol, 2014, 170(3): 720-724. doi: 10.1111/bjd.12690 [65] Olek-Hrab K, Maj J, Chmielowska E, et al. Methotrexate in the treatment of mycosis fungoides-a multicenter observational study in 79 patients[J]. Eur Rev Med Pharmacol Sci, 2018, 22(11): 3586-3594. [66] Zackheim HS, Kashani-Sabet M, McMillan A. Low-dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients[J]. J Am Acad Dermatol, 2003, 49(5): 873-878. doi: 10.1016/S0190-9622(03)01591-3 [67] Zackheim HS, Kashani-Sabet M, Hwang ST. Low-dose methotrexate to treat erythrodermic cutaneous T-cell lymphoma: results in twenty-nine patients[J]. J Am Acad Dermatol, 1996, 34(4): 626-631. doi: 10.1016/S0190-9622(96)80062-4 [68] Fierro MT, Doveil GC, Quaglino P, et al. Combination of etoposide, idarubicin, cyclophosphamide, vincristine, prednisone and bleomycin (VICOP-B) in the treatment of advanced cutaneous T-cell lymphoma[J]. Dermatology, 1997, 194(3): 268-272. doi: 10.1159/000246116 [69] Akpek G, Koh HK, Bogen S, et al. Chemotherapy with etoposide, vincristine, doxorubicin, bolus cyclophosphamide, and oral prednisone in patients with refractory cutaneous T-cell lymphoma[J]. Cancer, 1999, 86(7): 1368-1376. doi: 10.1002/(SICI)1097-0142(19991001)86:7<1368::AID-CNCR37>3.0.CO;2-8 [70] Hughes CF, Khot A, McCormack C, et al. Lack of durable disease control with chemotherapy for mycosis fungoides and Sézary syndrome: a comparative study of systemic therapy[J]. Blood, 2015, 125(1): 71-81. doi: 10.1182/blood-2014-07-588236 [71] Scarisbrick JJ, Taylor P, Holtick U, et al. U.K. consensus statement on the use of extracorporeal photo-pheresis for treatment of cutaneous T-cell lymphoma and chronic graft-versus-host disease[J]. Br J Dermatol, 2008, 158(4): 659-678. doi: 10.1111/j.1365-2133.2007.08415.x [72] Alfred A, Taylor PC, Dignan F, et al. The role of extracorporeal photopheresis in the management of cutaneous T-cell lymphoma, graft-versus-host disease and organ transplant rejection: a consensus statement update from the UK Photopheresis Society[J]. Br J Haematol, 2017, 177(2): 287-310. doi: 10.1111/bjh.14537 [73] Duarte RF, Boumendil A, Onida F, et al. Long-term outcome of allogeneic hematopoietic cell transplantation for patients with mycosis fungoides and Sezary syndrome: a European society for blood and marrow transplantation lymphoma working party extended analysis[J]. J Clin Oncol, 2014, 32(29): 3347-3348. doi: 10.1200/JCO.2014.57.5597 [74] Kothari R, Szepietowski JC, Bagot M, et al. Mycosis fungoides in pediatric population: comprehensive review on epidemiology, clinical presentation, and management[J]. Int J Dermatol, 2022, 61(12): 1458-1466. doi: 10.1111/ijd.16098 [75] Wu JH, Cohen BA, Sweren RJ. Mycosis fungoides in pediatric patients: Clinical features, diagnostic challenges, and advances in therapeutic management[J]. Pediatr Dermatol, 2020, 37(1): 18-28. doi: 10.1111/pde.14026 [76] Wohlmuth-Wieser I. Primary cutaneous T-cell lymphomas in childhood and adolescence[J]. J Dtsch Dermatol Ges, 2021, 19(4): 563-581. [77] Amitay-Layish I, David M, Kafri B, et al. Early-stage mycosis fungoides, parapsoriasis en plaque, and pregnancy[J]. Int J Dermatol, 2007, 46(2): 160-165. [78] Fatemi Naeini F, Abtahi-Naeini B, Najafian J, et al. Correlation between mycosis fungoides and pregnancy[J]. Saudi Med J, 2016, 37(9): 968-972. doi: 10.15537/smj.2016.9.15838 [79] Willemze R. Mycosis fungoides variants-clinicopathologic features, differential diagnosis, and treatment[J]. Semin Cutan Med Surg, 2018, 37(1): 11-17. doi: 10.12788/j.sder.2018.004 [80] van Santen S, van Doorn R, Neelis KJ, et al. Recommendations for treatment in folliculotropic mycosis fungoides: report of the Dutch Cutaneous Lymphoma Group[J]. Br J Dermatol, 2017, 177(1): 223-228. doi: 10.1111/bjd.15355 [81] Boulos S, Vaid R, Aladily TN, et al. Clinical presenta-tion, immunopathology, and treatment of juvenile-onset mycosis fungoides: a case series of 34 patients[J]. J Am Acad Dermatol, 2014, 71(6): 1117-1126. doi: 10.1016/j.jaad.2014.07.049 [82] Agar NS, Wedgeworth E, Crichton S, et al. Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal[J]. J Clin Oncol, 2010, 28(31): 4730-4739. doi: 10.1200/JCO.2009.27.7665 [83] Mourad A, Gniadecki R. Overall survival in mycosis fungoides: a systematic review and meta-analysis[J]. J Invest Dermatol, 2020, 140(2): 495-497. e5. doi: 10.1016/j.jid.2019.07.712 [84] Scarisbrick JJ, Prince HM, Vermeer MH, et al. Cutaneous lymphoma international consortium study of outcome in advanced stages of mycosis fungoides and sézary syndrome: effect of specific prognostic markers on survival and development of a prognostic model[J]. J Clin Oncol, 2015, 33(32): 3766-3773. doi: 10.1200/JCO.2015.61.7142 [85] 刘洁, 王宝玺, 渠涛, 等. 51例蕈样肉芽肿临床特征[J]. 中国医学科学院学报, 2007, 29(2): 174-180. doi: 10.3321/j.issn:1000-503X.2007.02.006 [86] Goyal A, O'Leary D, Goyal K, et al. Increased risk of second primary hematologic and solid malignancies in patients with mycosis fungoides: a surveillance, epidemiology, and end results analysis[J]. J Am Acad Dermatol, 2020, 83(2): 404-411. doi: 10.1016/j.jaad.2019.07.075 -
点击扫码阅读文章
图(2) / 表(9)
计量
- 文章访问数: 106
- HTML全文浏览量: 24
- PDF下载量: 46
- 被引次数: 0
