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Blood, 15 September 2007, Vol. 110, No. 6, pp. 1713-1722.
Prepublished online as a Blood First Edition Paper on May 31, 2007; DOI 10.1182/blood-2007-03-055749.


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PERSPECTIVE

Revisions to the staging and classification of mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)

Elise Olsen1, Eric Vonderheid2, Nicola Pimpinelli3, Rein Willemze4, Youn Kim5, Robert Knobler6, Herschel Zackheim7, Madeleine Duvic8, Teresa Estrach9, Stanford Lamberg2, Gary Wood10, Reinhard Dummer11, Annamari Ranki12, Gunter Burg11, Peter Heald13, Mark Pittelkow14, Maria-Grazia Bernengo15, Wolfram Sterry16, Liliane Laroche17, Franz Trautinger6, Sean Whittaker18, for the ISCL/EORTC

1 Department of Medicine, Divisions of Dermatology and Oncology, Duke University Medical Center, Durham, NC; 2 Department of Dermatology, Johns Hopkins University, Baltimore, MD; 3 Department of Dermatological Sciences, University of Florence, Florence, Italy; 4 Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands; 5 Department of Dermatology, Stanford University Medical Center, Stanford, CA; 6 Department of Dermatology, University of Vienna, Vienna, Austria; 7 Department of Dermatology, University of California at San Francisco; 8 Department of Dermatology, University of Texas at Houston; 9 Department of Dermatology, University of Barcelona, Barcelona, Spain; 10 Department of Dermatology, University of Wisconsin, Madison; 11 Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; 12 Department of Dermatology and Venereal Diseases, Helsinki University Hospital, Helsinki, Finland; 13 Department of Dermatology, Yale University, New Haven, CT; 14 Department of Dermatology, Mayo Clinic, Rochester, MN; 15 Department of Dermatology, University of Turin, Turin, Italy; 16 Department of Dermatology, Charité, Humboldt University, Berlin, Germany; 17 Department of Immuno-Dermatology, Hospital Avicenne–University of Paris XIII, Paris, France; 18 St John's Institute of Dermatology, Skin Tumour Unit, St Thomas' Hospital, London, United Kingdom

The ISCL/EORTC recommends revisions to the Mycosis Fungoides Cooperative Group classification and staging system for cutaneous T-cell lymphoma (CTCL). These revisions are made to incorporate advances related to tumor cell biology and diagnostic techniques as pertains to mycosis fungoides (MF) and Sézary syndrome (SS) since the 1979 publication of the original guidelines, to clarify certain variables that currently impede effective interinstitution and interinvestigator communication and/or the development of standardized clinical trials in MF and SS, and to provide a platform for tracking other variables of potential prognostic significance. Moreover, given the difference in prognosis and clinical characteristics of the non-MF/non-SS subtypes of cutaneous lymphoma, this revision pertains specifically to MF and SS. The evidence supporting the revisions is discussed as well as recommendations for evaluation and staging procedures based on these revisions.


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