Cutaneous (Skin) Lymphoma Treatment and Survival Rate

July 13, 2024

This page was reviewed under our medical and editorial policy by Alex Herrera, M.D., associate professor, division of lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope^® Cancer Center Duarte

Cutaneous (skin) lymphomas are a rare type of non-Hodgkin lymphoma and are hard to diagnose because they often resemble skin conditions such as eczema, psoriasis or ringworm. These factors often lead to a delay in treatment, underscoring the importance of seeing an expert familiar with recognizing these subtle differences. An accurate skin lymphoma diagnosis is the first step to developing a personalized treatment plan.

Each patient's cutaneous lymphoma treatment plan is based on several factors:

• The type of skin lymphoma
• Whether it has spread beyond the skin
• General health of the patient
• Age, gender and ethnicity
• Elevated blood levels of lactic dehydrogenase (LDH)
• If the disease has recurred
• Response to other treatments

These factors help the care team decide on a treatment plan. In the early stages, treatment may be limited to the skin.

If the disease has advanced or does not respond to the initial approach, a combination of skin-directed and system-directed therapies may be deployed.

Treatment for Skin Lymphoma

Skin lymphoma treatment plans are skin-directed if the patient is in the early stages. Disease that is more advanced, or more aggressive forms of skin lymphoma, such as Sézary syndrome, may require combining skin-directed treatments with a systemic approach.

Some of these treatments may include those listed below.

Topical treatments: These are drugs applied directly to the skin to harm lymphoma cells or boost the immune system response on the skin. They may include corticosteroids, retinoids, topical chemotherapy or immunotherapy drugs.

Phototherapy: This is a form of light therapy using ultraviolet (UV) rays. UV light is what causes sunburn and skin cancer, and phototherapy harnesses this light to destroy skin cancer cells. Ultraviolet A (UVA) and ultraviolet B (UVB) are both used to treat skin lymphoma. UVA is most often used, in combination with light-activated drugs called psoralens.

Radiation therapy: This treatment uses a high-energy beam to destroy cancer cells and shrink tumors. Electron beam therapy (EBT) penetrates only the skin and is limited to the tumor, so there are few side effects. Total skin electron beam (TSEB) is applied to the entire skin surface and has more side effects.

Extracorporeal photopheresis: ECP involves a three-step process. A small sample of blood is taken from the patient. The lymphocytes are separated, treated with a light-activated drug and UVA light, remixed with the blood and injected back into the patient.

Biological response modifiers: These treatments, such as interferon, work to repair genetic abnormalities in cancer cells.

Targeted therapies: Some targeted therapies zero in on specific parts of the lymphoma cells to keep them from growing. Others boost the immune system to target cancer cells.

Chemotherapy: These drugs are powerful agents applied directly to the skin, taken by mouth or delivered intravenously. Unlike targeted therapy, chemotherapy affects healthy cells as well as cancer cells and is often associated with more side effects.

Stem cell transplant: For patients with recurrent or particularly aggressive disease, transplantation may be a treatment option. Transplants use stem cells from various sources — including the patient, siblings and other family members, cord blood and unrelated matching donors — to restore healthy blood cells in the bone marrow. Reduced-intensity stem cell transplants minimize the toxic effects of chemotherapy used to prepare the body for the procedure.

Clinical trials: City of Hope is at the forefront of developing new therapies for cancer treatment, and skin lymphomas are no exception. Patients may be able to participate in trials of these innovative therapies.

Skin Lymphoma Survival Rate

One of the most important questions patients ask after a cancer diagnosis concerns their chances of surviving. Survival rates are statistical estimates of how many patients are still alive at least five years after their diagnosis. They are based on previous patients and do not account for advances in treatment or personal factors.

Factors affecting an individual patient’s prognosis include their age and how advanced and complex their cancer is, as well as their overall health. The rarity of skin lymphoma makes survival rates challenging to define. In general, disease that is limited to the skin has more favorable outcomes than advanced disease.

According to a 2020 meta-analysis in the Journal of Investigative Dermatology, the five-year survival rate for patients in the early stages of mycosis fungoides, the most common form of skin lymphoma, is estimated between 88.8% and normal life expectancy. Patients with more advanced disease showed lower five-year survival rates of between 39.7% and 67.9%.