How to treat primary cutaneous B cell lymphoma - Results from a monocentric cohort study on 98 patients.

Abstract

Background: Primary cutaneous B cell lymphomas (CBCL) are chronic diseases with frequent relapses. Time to next treatment (TTNT) is an endpoint reflecting clinical benefit of treatments including patient perspectives. The objectives were to evaluate clinical characteristics, survival, prognosis and TTNT in CBCL.

Patients and methods: In this monocentric study, clinical data were extracted between 1998 and 2022. TTNT were calculated. Univariate and multivariate analyses were conducted.

Results: Altogether, 46 patients with follicle center lymphoma (pcFCL), 41 with marginal zone lymphoproliferative disorder (pcMZLPD) and 11 with diffuse large B-cell lymphoma, leg type (DLBCL-LT) were identified. 26% of pcFCL patients relapsed frequently. The 5-year relapse-free survival was 71%, 87% and 23% in pcFCL, pcMZLPD and DLBCL-LT, respectively. In pcFCL and pcMZLPD, skin-directed treatments, such as excision or intralesional triamcinolone, performed best based on TTNT, while chemotherapy achieved a mean TTNT of 38 months in DLBCL-LT. In multivariate analysis of all patients, leg involvement was significantly associated with a decreased TTNT of the first treatment, while comorbidities were associated with an increased TTNT.

Conclusions: DLBCL-LT had the worst survival. Skin-directed treatments tend to achieve higher TTNT in pcFCL and pcMZLPD, while systemic treatments had higher TTNT in DLBCL-LT.