Answers from the Experts April 2021

April 2021 - Drs. Madeleine Duvic and Richard Hoppe respond to questions about cutaneous lymphoma and its treatment. (Click on "Show More" for Q&A timestamp)
Clinical Panel
Madeleine Duvic, MD, UT MD Anderson Cancer Center
Richard Hoppe, MD, Stanford Cancer Center
Timestamps
00:32 As it can take years to correctly diagnose cutaneous lymphoma with biopsies, are there any new ways to diagnose it sooner? And how does the patient cope until diagnosed?
03:29 Is CTCL considered a skin cancer as opposed to a blood cancer?
04:59 Is there a recommended interval for cytology testing for early stage mycosis fungoides if the person is currently receiving no treatment and is in remission?
06:25 Is it possible for mycosis fungoides plaques and tumors to return to specific areas that have been previously treated with radiation therapy?
07:28 What are treatment options for folliculotropic mycosis fungoides (FMF)?
08:45 What are treatment options for cutaneous B-cell lymphoma (other than radiation or rituximab)?
10:16 Why might a biopsied skin area found to have CD30 component not respond to rituximab?
11:23 What are the different types of phototherapy?
13:09 With CTCL, when can you "watch and wait"?
14:54 If you are diagnosed at 2B, is it possible to be downgraded back to stage 1 or will I always be a stage 2 patient?
15:57 When do you decide to use interferon treatment and how long do you wait before changing to other treatments?
17:07 Is it safe to have the Covid vaccine if you are currently on brentuximab? What about rituximab?
18:01 Is tanning a safe form of treatment after radiation? How long does the skin need to heal from radiation?
19:53 I'm responding well to treatment for folliculotropic MF and my PET and CT flow cytology are clear. When do you go to further treatment?
20:19 Is there a problem with using dry eye treatments, such as Restatis eye drops, which are supposed to work with T-cells in the eye in order to be effective?
21:27 If there is no presence of blood involvement only skin involvement with regards to MF, is there a risk of blood involvement in the future?
22:27 Have you seen CTCL lead to macular amyloidosis from the profound itching? Are they treated the same and by the same dermatologist?
23:14 Are immune suppressed patients receiving protection from any or all of the Covid vaccines (currently) available?
23:39 Under what conditions are additional biopsies called for?
25:19 How can you determine if a plaque that returns after radiation treatment is MF? What are treatment options? Is excision a good option for MF lesions?
27:19 If the side effects of brentuximab negatively affect the patient's overall well-being, is it time to switch to another type of treatment?
28:52 Which type of doctor inject rituximab into lesions?
30:49 Because FMF is more difficult to treat, do I need an expert in FMF or is a doctor with knowledge of mycosis fungoides sufficient?
31:49 Since the efficacy of (Covid) vaccines for lymphoma patients is not known, what do recommend to your patients who have been vaccinated?
33:08 Is there a difference between Clobetasol and Halobetasol for treating skin lesions from LyP?
33:20 What are your thoughts on Dupixent for patients with MF and atopic dermatitis?
34:22 Are biopsies recommended for plaques that reappear after electron beam radiation to confirm that its MF and not something else?
35:16 What are your thoughts on Protopic for facial plaques or patches?
35:59 Is a partial response or stable disease response to a specific medicine a good outcome or is it always a complete response to treatment the preferred outcome?
38:10 Are there complications from using Clobetasol for a long period of time? Is it dangerous to rub the ointment all over?
39:54 After two biopsies to confirm MF with large cell transformation, my tumor went away and didn't come back - so why not biopsy all superficial cd30 MF large cell transformation tumors with the expectation the tumor will go away?
40:55 For those who have had the vaccine and not sure if it is effective due to lymphoma and prior treatments with rituximab, can an antibody test resolve these uncertainties?
42:16 Can the possibility of a cure be objectively ascertained via testing?
43:45 What are treatment options for stage 4 Sezary? Are there treatments that can be combined with mogamulizumab to improve skin conditions?
45:32 Is hypopigmented MF considered a variant subtype of its own or is it just considered an atypical presentation of classical MF?
46:24 After completing phototherapy with clinical resolution of lesions, is there good evidence behind doing maintenance phototherapy for MF patients?
47:30 What treatments other than photophoresis targets involvement in the blood?
48:03 I have nail involvement with FMF, should commercial manicures or pedicures be avoided? What treatments are available (for the nails)?
49:00 What are treatment options for multiple lesions on the face and scalp due to PCALCL?