Management Strategies for Mycosis Fungoides in India

Area of Science:

• Dermatology
• Oncology
• Hematology

Background:

• Mycosis fungoides is the most prevalent primary cutaneous T-cell lymphoma.
• Diagnosis and follow-up protocols are essential for patient management.
• Treatment decisions traditionally follow a Tumor Node Metastasis Blood (TNMB) staging system.

Purpose of the Study:

• To outline the diagnostic and follow-up approach for mycosis fungoides.
• To discuss available treatment options in India based on risk stratification.
• To highlight the need for multidisciplinary care in advanced stages.

Main Methods:

• Review of evidence for interventions based on TNMB staging.
• Discussion of treatment modalities categorized by risk stratification and prognostic index.
• Identification of therapeutic options suitable for the Indian healthcare context.

Main Results:

• Early-stage, low-risk patients benefit from expectant policy or skin-directed therapies (topical steroids, phototherapy).
• Intermediate-risk patients may receive interferons, retinoids, low-dose methotrexate, or radiotherapy (total skin electron beam therapy).
• High-risk patients typically require palliative chemotherapy (single or multiagent).

Conclusions:

• Treatment for mycosis fungoides is stage- and risk-dependent.
• Limited treatment options exist in India, necessitating careful stratification.
• Intermediate- and high-risk patients require specialized multidisciplinary management at tertiary care centers.