[T-cell lymphoma of the skin--clinicopathological relationships, therapy and survival]

We investigated the pretreatment characteristics and prognosis of T-cell lymphomas, including mycosis fungoides (MF), T-cell lymphoma of the skin other than MF (CTL), adult T-cell leukemia/lymphoma (ATL), immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma and angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), as well as B-cell lymphoma of the skin (CBL) and analyzed the prognostic factors for skin T-cell lymphoma when the skin was the organ initially or predoienantly involved. Twenty-eight cases of erythematous-stage MF, ten cases of plaque-stage MF, eleven cases of tumor-stage MF, twelve cases of ATL, eleven cases of IBL-like T-cell lymphoma/AILD, and eight cases of CBL were studied. CTCL patients were treated by photochemotherapy with topical 8-methoxypsoralen (8-MOP) followed by VUA irradiation, electron-beam irradiation, or systemic chemotherapy. Complete remission (CR) was obtained with all of these therapies. However induction of CR was not a major prognostic factor in skin T-cell lymphoma, and the clinical stage was more valuable in this respect. No cases of death occurred among erythematous-stage MF patients, but eight out of 11 patients with tumor-stage MF died (mean survival rate, 38 months). The prognosis for tumor-stage MF was better than that of ATL (19 months) or IBL-like T cell lymphoma/AILD (28 months), but worse than those of erythematous-a plaque-stage MF. TNM staging of CTCL was also a useful factor for prognosis.