Cutaneous T-cell lymphoma with CNS involvement: a case series and review of the literature

Author:

Preston Joshua D12ORCID,Jansen Caroline S13ORCID,Kosaraju Siddhartha4,Niyogusaba Tim5ORCID,Zhuang Tony Z6ORCID,Iwamoto Sally W7,Hutto Spencer K7ORCID,Lechowicz Mary Jo8,Allen Pamela B8ORCID

Affiliation:

1. Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA 30322, USA

2. Nutrition & Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA

3. Emory University School of Medicine, Atlanta, GA 30322, USA

4. Division of Neuroradiology, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA

5. Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA

6. Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA

7. Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA

8. Department of Hematology & Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA

Abstract

Cutaneous T-cell lymphoma (CTCL) is a rare hematologic malignancy that traditionally presents with cutaneous lesions, though metastases are not uncommon in progressive disease. We describe four cases of CTCL with central nervous system (CNS) involvement, detailing the history, pathological characteristics, treatment response, and progression. Median time from initial diagnosis to CNS metastasis was ∼5.4 years (range 3.4–15.5 years) and survival after metastasis was ∼160 days (range 19 days–4.4 years). No patients achieved long-term (>5 years) survival, though some displayed varying degrees of remission following CNS-directed therapy. We conclude that clinicians must be attentive to the development of CNS metastases in patients with CTCL. The growing body of literature on such cases will inform evolving therapeutic guidelines on this rare CTCL complication.

Funder

Conquer Cancer Foundation

National Cancer Institute

Lymphoma Research Foundation

National Institute of General Medical Sciences

Publisher

Future Medicine Ltd

Subject

Neurology (clinical),Neurology

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