Evaluation of different methods in the follow-up of patients with indolent types of primary cutaneous lymphomas.

BACKGROUND: Primary cutaneous lymphomas (CLs) are a heterogeneous group of diseases arising from B or T lymphocytes. CLs are grouped according to their clinical behaviour into indolent, intermediate and aggressive types. Indolent CLs respond well to therapy but frequently relapse, resulting in prolonged periods of follow-up. OBJECTIVES: To evaluate the outcome of follow-up examinations in indolent CL. METHODS: We retrospectively analysed a cohort from a CL outpatient clinic at a tertiary referral centre. Seventy-five patients with indolent cutaneous T-cell lymphomas (CTCLs) and 34 patients with indolent cutaneous B-cell lymphomas (CBCLs) were included. The value of clinical examination, blood tests and imaging procedures for detection of recurrence or progression was assessed. RESULTS: In patients with CTCL all but one disease recurrences were detected by clinical examination. Lymph node or organ involvement was detected by imaging procedures in seven patients, of whom all but one had recurrent or persistent CL lesions. In CBCL all recurrences were detected by clinical examination. CONCLUSIONS: Patients with indolent CL confined to the skin should be followed primarily by clinical examination. However, in patients who are refractory to treatment regular screening of lymph nodes by ultrasound may enable earlier detection of disease recurrence or progression.

Treatment of cutaneous lymphomas: today and tomorrow.

There exist many skin-directed and systemic immunomodulating or cytotoxic treatment options for primary cutaneous T- and B-cell lymphomas. However, especially in advanced stages conventional therapies only end in a transient remission without curative results unable to prolong overall survival. Over the last twenty years the high need of new therapeutic strategies resulted in the development of emerging drugs targeting more tumor specific, like monoclonal antibodies, histone-deacetylase inhibitors, proteasome inhibitors, or fusion proteins. This article aims to discuss the conventional treatment modalities as well as new therapeutic strategies, which passed already through clinical trials showing promising results in the treatment of primary cutaneous lymphomas.

FGFR4 Arg388 allele correlates with tumour thickness and FGFR4 protein expression with survival of melanoma patients.

A single nucleotide polymorphism in the gene for FGFR4 (-Arg388) has been associated with progression in various types of human cancer. Although fibroblast growth factors (FGFs) belong to the most important growth factors in melanoma, expression of FGF receptor subtype 4 has not been investigated yet. In this study, the protein expression of this receptor was analysed in 137 melanoma tissues of different progression stages by immunohistochemistry. FGFR4 protein was expressed in 45% of the specimens and correlated with pTNM tumour stages (UICC, P = 0.023 and AJCC, P = 0.046), presence of microulceration (P = 0.009), tumour vascularity (P = 0.001), metastases (P = 0.025), number of primary tumours (P = 0.022), overall survival (P = 0.047) and disease-free survival (P = 0.024). Furthermore, FGFR4 Arg388 polymorphism was analysed in 185 melanoma patients by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The Arg388 allele was detected in 45% of the melanoma patients and was significantly associated with tumour thickness (by Clark's level of invasion (P = 0.004) and by Breslow in mm (P = 0.02)) and the tumour subtype nodular melanoma (P = 0.002). However, there was no correlation of the FGFR4 Arg388 allele with overall and disease-free survival. In conclusion, the Arg388 genotype and the protein expression of FGFR4 may be potential markers for progression of melanoma.