Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses the treatment of cutaneous T-cell lymphoma (CTCL). At the 17th International Congress on Hematologic Malignancies, Pinter-Brown spoke about the factors that weigh into a physician's decision concerning the treatment of CTCL.

A physician needs to understand which CTCL is being treated. The stage of the disease is also crucial, as it determines whether the disease needs local or systemic treatment. Other considerations include comorbidities, route of administration, and availability of treatment. A physician must also be aware of how quickly a treatment works and how quickly a patient needs a response.

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Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses the treatment of cutaneous T-cell lymphoma.

Dr. Pinter-Brown Discusses Treatment Decisions for CTCL

Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, gives an overview of treatment with chemotherapy for patients with cutaneous T-cell lymphoma (CTCL).

If a patient with CTCL has early-stage disease, Pinter-Brown believes that treatment with chemotherapy or a systemic therapy should not be obligated. At this point, treating a patient with chemotherapy may not be in the patient's best interest, Pinter-Brown believes. These patients should be followed closely, to monitor for change. 

A diagnosis of mycosis fungoides, the most common form of CTCL, often leads to treatment with CHOP or other chemotherapies, which will elicit a beneficial response. However, the response is generally very short with high toxicity. Pinter-Brown stresses that mycosis fungoides must be treated as a chronic disease, since patients must live with the disease and side effects of treatment. Due to this, quality of life and comfort should always be a priority.

Lauren Pinter-Brown, MD, from the University of California, Los Angeles, gives an overview of treatment with chemotherapy for patients with cutaneous T-cell lymphoma.

Dr. Pinter-Brown on Treating CTCL With Chemotherapy

Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses physician and patient expectations when treating cutaneous T-cell lymphoma (CTCL).

As with other oncologic conditions, if a patient is being treated with a drug and progresses, it is obvious that the drug is ineffective. In patients with CTCL, physicians have to be aware of the time to response for particular treatments, as they're not identical.

In the case of bexarotene, the time to response is four months, which causes physicians and patients to set appropriate expectations as the patient's condition will not worsen but it will not get better for many months. Fortunately, monitoring CTCL does not require scans or blood tests: physicians simply have to monitor skin lesions as time passes.

Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses physician and patient expectations when treating cutaneous T-cell lymphoma.

Dr. Pinter-Brown on Treatment Expectations in CTCL

Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses combination therapies in cutaneous T-cell lymphoma (CTCL).

Combination therapies in CTCL have not been studied a great deal. There is a desire for many practicing physicians to "layer" treatments that only garner some response to prevent the disease from breaking loose, Pinter-Brown says. As a result, patients are often treated with combinations that have not been studied. There are some combination therapies that have been studied: retinoids with light, interferon with light, photopheresis with interferon, and photopheresis with retinioids.

Lauren Pinter-Brown, MD, Clinical Professor, Department of Medicine, Hematology-Oncology, University of California, Los Angeles, discusses combination therapies in cutaneous T-cell lymphoma.

Lauren Pinter-Brown, MD

Articles

Dr. Pinter-Brown Discusses Treatment Decisions for CTCL

Dr. Pinter-Brown on Treating CTCL With Chemotherapy

Dr. Pinter-Brown on Treatment Expectations in CTCL

Dr. Pinter-Brown on CTCL Combination Therapies