Mielke V, Staib G, Sterry W
Department of Dermatology, University of Ulm, Germany.
Recent Results Cancer Res. 1995;139:403-8. doi: 10.1007/978-3-642-78771-3_31.
Primary malignant T cell lymphomas of the skin form a heterogenous group. Relevant classifications were recently made to separate different entities by various criteria. This is of great importance, because one should only rely on those therapeutical trials in which patients were included according such classifications. In this paper, we will mainly focus on therapeutic modalities for mycosis fungoides, which is the most frequent cutaneous T cell lymphoma and which may serve as a model disease. In principle, local (e.g., psoralens and ultraviolet A, PUVA) and systemic therapies (e.g., interferon-alpha 2a) can be applied. Very recently, we were able to demonstrate that even in initial stages of mycosis fungoides, the T cell clone is not restricted to the skin, but rather is present in low amounts in the peripheral blood. Therefore, systemic therapeutic modalities alone or in combination with local strategies (interferon-alpha 2a and acitretin/PUVA and interferon-alpha 2a) should be more effective, which will be proven by currently running clinical trials.
原发性皮肤恶性T细胞淋巴瘤构成了一个异质性群体。最近通过各种标准进行了相关分类，以区分不同的实体。这非常重要，因为人们应该只依赖那些根据此类分类纳入患者的治疗试验。在本文中，我们将主要关注蕈样肉芽肿的治疗方式，蕈样肉芽肿是最常见的皮肤T细胞淋巴瘤，可作为一种典型疾病。原则上，可以应用局部治疗（如补骨脂素和紫外线A，PUVA）和全身治疗（如干扰素-α 2a）。最近，我们能够证明，即使在蕈样肉芽肿的初始阶段，T细胞克隆也不仅限于皮肤，而是少量存在于外周血中。因此，单独的全身治疗方式或与局部策略（干扰素-α 2a和阿维A/PUVA以及干扰素-α 2a）联合应用应该更有效，这将在目前正在进行的临床试验中得到证实。
