Second neoplasm in cutaneous T-cell lymphoma patients: a marker of worse prognosis?

BACKGROUND: Epidemiologic studies have shown that cutaneous T-cell lymphoma (CTCL) patients have an increased risk of the development of a second neoplasm (SN). The aim of our study was to evaluate the risk of SNand to correlate any possible change in CTCLcourse after the diagnosis of a subsequent neoplasm. METHODS: Aten-year retrospective study was carried out in two centers (Bologna and Florence) all the patients who developed a SNsix months at least after a CTCLwere included. Two groups were selected: group 1 featuring patients who developed a SNand group 2 characterized by patients affected by MFage and sex-matched with group 1 (control group). Data concerning any stage change after SN, time between MF and SN onset, modified Severity Weighted Assessment Tool (mSWAT) score before and after SN, concerning Group 1 and after a median time of 36 months in Group 2 were analyzed. RESULTS: Thirteen patients were detected. Before SNonset, early MFpatients were mainly present, while SNcases ...

BACKGROUND: Epidemiologic studies have shown that cutaneous T-cell lymphoma (CTCL) patients have an increased risk of the development of a second neoplasm (SN). The aim of our study was to evaluate the risk of SNand to correlate any possible change in CTCLcourse after the diagnosis of a subsequent neoplasm. METHODS: Aten-year retrospective study was carried out in two centers (Bologna and Florence) all the patients who developed a SNsix months at least after a CTCLwere included. Two groups were selected: group 1 featuring patients who developed a SNand group 2 characterized by patients affected by MFage and sex-matched with group 1 (control group). Data concerning any stage change after SN, time between MF and SN onset, modified Severity Weighted Assessment Tool (mSWAT) score before and after SN, concerning Group 1 and after a median time of 36 months in Group 2 were analyzed. RESULTS: Thirteen patients were detected. Before SNonset, early MFpatients were mainly present, while SNcases in advanced stage (ten patients) were observed. SNtype predominant was lung cancer, along with prostate and pancreatic cancer, while isolated cases presenting with vulvar, colon, mammalian, prostate cancer along with Hodgkin's Lymphoma. Mean mSWAT at MF diagnosis and after SN showed a significant difference (P value = 0.0037). After SNdiagnosis, nine patients experienced an MFstage progression and ten patients died at follow-up. CONCLUSIONS: In all the instances, statistical analysis showed that mean mSWAT score before/after SN diagnosis had a significantly difference (P=0.0037) suggesting that patients with a SNmay have a worse clinical outcome. By secreting immunosuppressive cytokines or recruiting immunosuppressive cells, a sort of mutual help between the two neoplasms may be prompted. Our data suggested that SNdevelopment in MFpatients may be regarded as a worse prognostic marker.