Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Curr Oncol Rep. 2023 Nov;25(11):1397-1408. doi: 10.1007/s11912-023-01464-8. Epub 2023 Oct 24.
This review focuses on updates in prognosis, pathogenesis, and treatment of cutaneous T cell lymphoma (CTCL).
Cohort studies indicate imaging may be necessary in early-stage CTCL. Risk factors for progression of CTCL have been identified. Interactions between malignant cells and the tumor microenvironment (TME) and the skin microbiome advance the understanding of pathogenesis and tumor cell dissemination. Studies support a hypothesis of circulating malignant tumor cells. MicroRNA (miR) influence tumor progression and prognosis; the IL22-STAT3-CCL20 cascade may be a novel target. IL-4, IL-5, and IL-31 cytokines are relevant for pruritus and could be targets for therapeutic interventions. Systemic therapies, such as JAK inhibitors, targeted antibodies, and checkpoint inhibitors, show promise in advanced stages. Allogenic hematopoietic stem cell transplantation provides a potential curative option for patients. Further investigations of prognosis and translational research are necessary to improve stratification of patients for treatment.
本文重点介绍皮肤 T 细胞淋巴瘤（CTCL）的预后、发病机制和治疗方面的最新进展。
队列研究表明，早期 CTCL 可能需要进行影像学检查。已经确定了 CTCL 进展的危险因素。恶性细胞与肿瘤微环境（TME）和皮肤微生物组之间的相互作用促进了发病机制和肿瘤细胞扩散的理解。研究支持循环恶性肿瘤细胞假说。微小 RNA（miRNA）影响肿瘤的进展和预后；IL22-STAT3-CCL20 级联反应可能是一个新的靶点。IL-4、IL-5 和 IL-31 细胞因子与瘙痒有关，可能成为治疗干预的靶点。Jak 抑制剂、靶向抗体和检查点抑制剂等全身治疗在晚期显示出良好的疗效。同种异体造血干细胞移植为患者提供了一种潜在的治愈选择。进一步研究预后和转化研究对于改善患者的治疗分层是必要的。
