New Therapies and Immunological Findings in Cutaneous T-Cell Lymphoma.
New Therapies and Immunological Findings in Cutaneous T-Cell Lymphoma.
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皮肤T细胞淋巴瘤中的新疗法和免疫学发现。
DOI：
10.3389/fonc.2018.00198
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发表时间：
2018
影响因子：
4.7
通讯作者：
Fujii K
中科院分区：
文献类型：
--
作者：
Fujii K
原发性皮肤淋巴瘤包括一组主要发生在皮肤的淋巴恶性肿瘤。它们是结外非霍奇金淋巴瘤的第二常见形式，具有异质性的临床、组织学、免疫学和分子特征。最常见的类型是蕈样肉芽肿及其白血病变异型塞扎里综合征。这两种疾病都被认为是 2 型辅助 T 细胞 (Th2) 疾病。不仅肿瘤细胞，肿瘤微环境也能促进Th2分化，这对肿瘤细胞是有利的，因为Th1环境增强了抗肿瘤免疫反应。这种 Th2 主导的环境也是患者感染易感性的基础。许多成分，例如肿瘤相关巨噬细胞、癌症相关成纤维细胞和树突状细胞，以及趋化因子和细胞因子等体液因子，建立肿瘤微环境并可以改变肿瘤细胞迁移和增殖。多药化疗通常会引起免疫抑制，导致严重感染的风险增加和耐受性差。因此，应避免对此类淋巴瘤进行过度治疗。与化疗相比，干扰素已被证明可以更大程度地延长下次治疗的时间。皮肤T细胞淋巴瘤（CTCL）的发病机制和预后在不同亚型之间存在显着差异。在一些侵袭性 CTCL 亚型中，例如原发性皮肤 γ/δ T 细胞淋巴瘤和原发性皮肤 CD8+ 侵袭性表皮细胞毒性 T 细胞淋巴瘤，应考虑造血干细胞移植，而其他有利亚型应避免过度治疗。因此，需要深入了解皮肤淋巴瘤的发病机制和免疫学背景，以更好地治疗患有该疾病的患者。本综述总结了该领域的当前知识，以试图实现这一目标。
Primary cutaneous lymphomas comprise a group of lymphatic malignancies that occur primarily in the skin. They represent the second most common form of extranodal non-Hodgkin’s lymphoma and are characterized by heterogeneous clinical, histological, immunological, and molecular features. The most common type is mycosis fungoides and its leukemic variant, Sézary syndrome. Both diseases are considered T-helper cell type 2 (Th2) diseases. Not only the tumor cells but also the tumor microenvironment can promote Th2 differentiation, which is beneficial for the tumor cells because a Th1 environment enhances antitumor immune responses. This Th2-dominant milieu also underlies the infectious susceptibility of the patients. Many components, such as tumor-associated macrophages, cancer-associated fibroblasts, and dendritic cells, as well as humoral factors, such as chemokines and cytokines, establish the tumor microenvironment and can modify tumor cell migration and proliferation. Multiagent chemotherapy often induces immunosuppression, resulting in an increased risk of serious infection and poor tolerance. Therefore, overtreatment should be avoided for these types of lymphomas. Interferons have been shown to increase the time to next treatment to a greater degree than has chemotherapy. The pathogenesis and prognosis of cutaneous T-cell lymphoma (CTCL) differ markedly among the subtypes. In some aggressive subtypes of CTCLs, such as primary cutaneous gamma/delta T-cell lymphoma and primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, hematopoietic stem cell transplantation should be considered, whereas overtreatment should be avoided with other, favorable subtypes. Therefore, a solid understanding of the pathogenesis and immunological background of cutaneous lymphoma is required to better treat patients who are inflicted with this disease. This review summarizes the current knowledge in the field to attempt to achieve this objective.
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影响因子：
20.3
作者：
Berger, CL;Tigelaar, R;Edelson, RL
通讯作者：
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20.3
作者：
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通讯作者：
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