Radiotherapy in the Treatment of Primary Cutaneous CD4+ Small/Medium T-cell Lymphoproliferative Disorder

Authors

Susan Y Wu
Ethan P Damron
Jie Xu
Penny Q Fang
Julia Dai
Ranjit Nair
Luis E Malpica Castillo
Luis E Fayad
Carlos A Torres-Cabala
L Jeffrey Medeiros
Francisco Vega
Roberto N Miranda
Madeleine Duvic
Chelsea C Pinnix
Bouthaina S Dabaja
Swaminathan P Iyer
Auris O Huen
Jillian R Gunther

Language

English

Publication Date

2-1-2025

Journal

International Journal of Dermatology

DOI

10.1111/ijd.17352

PMID

38955474

PMCID

PMC11693774

PubMedCentral® Posted Date

2-1-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD) is an increasingly recognized entity with heterogeneous management strategies that may include radiotherapy.

Objective: Our aim was to characterize treatment options for PCSM-LPD, with a focus on the role of radiotherapy.

Methods: This is a retrospective review of 46 patients seen in the Cutaneous Lymphoma Program at the University of Texas MD Anderson Cancer Center, with a clinicopathologic review consistent with PCSM-LPD. All patients were biopsied and underwent observation, topical/intralesional steroids, and/or radiotherapy. Patients were confirmed to have residual disease prior to radiotherapy.

Results: All patients achieved a complete response (CR). Sixteen patients (35%) received focal radiotherapy, with a CR in 15 (94%). The CR rate following ultra-low-dose radiotherapy (4 Gy in 1-2 fractions) was 92%. There was no grade 3 toxicity after radiotherapy. Thirty patients were managed without radiotherapy, with excision and observation or steroids.

Conclusion: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder has excellent outcomes, and management strategies may include observation following biopsy, steroids, or radiation. Ultra-low-dose radiotherapy results in excellent outcomes with limited toxicity and is effective for persistent lesions after steroidal therapy.

Keywords

Humans, Retrospective Studies, Male, Female, Middle Aged, Aged, Adult, Aged, 80 and over, Skin Neoplasms, CD4-Positive T-Lymphocytes, Treatment Outcome, Lymphoma, T-Cell, Cutaneous, Lymphoproliferative Disorders, Remission Induction, Young Adult, Radiotherapy Dosage, t-cell lymphoproliferative disorder, radiotherapy, immunoglobulin, cutaneous neoplasms, cutaneous lymphoma

Published Open-Access

yes

Recommended Citation

Wu, Susan Y; Damron, Ethan P; Xu, Jie; et al., "Radiotherapy in the Treatment of Primary Cutaneous CD4+ Small/Medium T-cell Lymphoproliferative Disorder" (2025). Faculty, Staff and Student Publications. 5611.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5611