Massone Cesare, Rivoli Giulia, Sola Simona, Angelucci Emanuele
Dermatology Unit and Scientific Directorate, Galliera Hospital, Genoa.
Hematology and Cellular Therapies Operational Unit, IRCCS San Martino Polyclinic Hospital, Genoa.
Dermatol Reports. 2023 Aug 11;16(Suppl 2):9781. doi: 10.4081/dr.2023.9781. eCollection 2024 May 7.
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic neoplasm (less than 1% of primary cutaneous lymphomas and acute leukemia) with a highly aggressive clinical course and frequent skin, bone marrow and central nervous system involvement. Even though there is often an early response to chemotherapy, leukemic dissemination relapses are very common and result in poor outcomes, with a median overall survival of 8 to 14 months in the first-line setting using standard combination chemotherapy regimens. Almost 90% of patients experience skin involvement as their initial site of infection, where BPDCN may stay restricted for weeks or even months until a swift secondary phase involving multiple organs takes place. Consequently, it is crucial to suspect and identify early skin lesions, as well as to conduct and report a skin biopsy as soon as possible. In order to diagnose and treat BPDCN, a multidisciplinary strategy involving collaboration between pathologists, hematologists, and dermatologists is unquestionably essential.
母细胞性浆细胞样树突状细胞肿瘤(BPDCN)是一种罕见的血液系统肿瘤(占原发性皮肤淋巴瘤和急性白血病的比例不到1%),临床病程高度侵袭性,常累及皮肤、骨髓和中枢神经系统。尽管化疗通常会有早期反应,但白血病播散复发非常常见,导致预后不良,在一线治疗中使用标准联合化疗方案时,总生存期的中位数为8至14个月。近90%的患者最初表现为皮肤受累,BPDCN可能局限于皮肤数周甚至数月,直到迅速进入累及多个器官的第二阶段。因此,怀疑并尽早识别皮肤病变,以及尽快进行并报告皮肤活检至关重要。为了诊断和治疗BPDCN,涉及病理学家、血液学家和皮肤科医生合作的多学科策略无疑是必不可少的。