Answers from the Experts: Quarterly Q&A

January 2021 - Finding answers to your questions about cutaneous lymphoma and its treatments can be challenging. These open question and answer events provide access to expert clinicians to respond to your questions about cutaneous lymphoma. (Click on "See More" for Q&A timestamps)
Clinical Panel
Brad Haverkos, MD, MPH, MS, Anschutz Cancer Pavilion
Jasmine Zain, MD, City of Hope National Medical Center
Q&A Timestamps
00:02:13 What over-the-counter and prescribed creams do people use (especially for the itch)?
00:05:04 I am 69 and have had Sezary Syndrome since 2012. Now I am on vorinostat and the number of Sezary cells on blood tests is 63-35%. Is there information on the use of immunotherapy, like Keytruda, in my case? Also, I have vials of Poteligeo but hesitate to use it due to after effects.
00:09:35 Is there any known link or correlation between LyP (lymphomatoid papulosis) and developing small fiber neuropathy?
00:10:06 What should CTCL patients be aware of with respect to COVID vaccines?
00:14:31 I have been told after my second biopsy that I have non-aggressive MF. I have had it for over 26 year. Can I safely assume that my MF will not become a more aggressive form?
00:15:49 I have been using methotrexate for four years. I stopped once, and it was not pretty. What are your thoughts for how long I should stay on it?
00:17:44 I'd like to know if there are any treatments that can be used for stage 4 transformed Sezary Syndrome beyond the standard treatments? Are there any drugs or other treatments on the horizon that could be promising?
00:20:55 Does methotrexate or other systemic medications improve prognosis?
00:23:10 When would it be recommended to have a flow cytometry test?
00:24:56 I am a 54 year old female, diagnosed with stage 2 MF in 2013. After multiple treatments I was switched to interferon in 2016 with 90% efficacy. Merck is discontinuing interferon in May 2021. Do you have guidance on how to safely taper off of interferon a?
00:26:21 What other treatment options for MF might be available now for controlling symptoms and managing disease now that Merck is discontinuing interferon (I am in Canada)?
00:28:27 Do patients with CTCL have additional recovery issues if they become infected with COVID.
00:29:56 What are your COVID recommendations for B-cell patients regarding care with Rituxan? Should I get vaccinated or not?
00:31:06 In regards to CTCL, CD30+ lymphoproliferative disorders, and anaplastic large cell lymphoma, is there a difference in prognosis?
00:34:23 I was recently diagnosed with MF. How can I keep it from spreading to the blood or organs?
00:35:39 Sometimes my white count is low. I don't understand what this means with CTCL, and why it will be normal sometimes.
00:36:44 I was a firefighter. Did exposure to chemicals make my condition worse?
00:37:56 I have MF stage 1b, diagnosed for the past 4 years, with 2 stubborn plaques that are not responsive to UVb and cortisone ointments. My local dermatologist suggested injecting with Kenalog. What is your opinion of injecting a stubborn plaque for the long term, and does this mean I am not progressing?
00:39:24 Is valchlor more effective than systemic treatment with immunosuppressive therapy like CellCept for early stage MF.
00:41:43 What criteria is used to determine if cutaneous lymphoma is controlled?
00:43:31 My husband was diagnosed with transformed MF as one of the patches had CD30 expression. All of the tests that he had done, such as PET scan, and bone marrow came back clear. The patch went away spontaneously. His hematologist recommended radiotherapy to "put the lid" on the patch. Is this a standard approach?
00:45:09 I have anaplastic large cell lymphoma and CTCL, and was just taken off of methotrexate. I'm getting new lesions adjacent to where I got radiation three weeks after stopping methotrexate. Is this concerning?
00:47:05 My husband is a Sezary Syndrome patient with large cell transformation. He had an allogenic transplant in 2014 and is CD30 negative. He has had multiple treatments, including multiple drugs, radiation, and just flunked a trial. Is duvelisib a reasonable next step, and can it be used outside a trial with another drug, or would you recommend something different?
00:51:00 Can you comment on the role of sunlight in managing CTCL? Do you recommend it or not, with or without sunscreen?
00:52:26 I am new to a stage 1 CTCL diagnosis. They started me on a two week, twice a day, betamethasone then I'm going to twice a day targretin. Is this the safest and best way to start?