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Primary Cutaneous B-Cell Lymphoma

Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT

To the Editor:

We read with great interest the article by Zinzani et al¹ regarding primary cutaneous B-cell lymphoma and associated clinical outcomes. The authors conclude that diffuse large B-cell lymphoma, leg type, has a significantly worse prognosis compared with follicle center and marginal-zone B-cell lymphomas of the skin with respect to overall survival. This study is important as it confirms the findings of several smaller studies such as that by Grange et al² which previously identified disseminated disease and leg involvement as adverse prognostic features. The authors reference this important study in their text as "the previous largest series" of 145 patients, but the reference provided includes a variety of patients with T-cell lymphomas.³ We believe the authors intended to reference the series by Grange et al² published in the Journal of Clinical Oncology in 2001, which specifically focused on patients with primary cutaneous B-cell lymphoma.

In 2005, our group published an analysis of nearly 1,000 patients with primary cutaneous B-cell lymphoma based on data from the Surveillance, Epidemiology and End Results program registry.⁴ That series spanned 1973 to 2001 and demonstrated the prognostic relationships between Surveillance, Epidemiology and End Results histology (which included over 400 patients with diffuse large B-cell lymphoma), anatomic location, and relative survival as well as adjusted risk of death. These findings served as the basis for a primary cutaneous B-cell lymphoma prognostic index that incorporates the combination of histology and anatomic distribution with adjustment for age, sex, race, and treatment with radiotherapy.

We feel that the findings of Zinzani et al¹ are complementary and supportive to the primary cutaneous B-cell lymphoma prognostic index and that the clinical results from these large data sets, in addition to the other supportive literature, should serve as the basis on which future clinical decisions and prospective study should be based.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCES

1. Zinzani PL, Quaglino P, Pimpinelli N, et al: Prognostic factors in primary cutaneous B-cell lymphoma: The Italian Study Group for Cutaneous Lymphomas. J Clin Oncol 24:1376-1382, 2006[Abstract/Free Full Text]

2. Grange F, Bekkenk MW, Wechsler J, et al: Prognostic factors in primary cutaneous large B-cell lymphomas: A European multicenter study. J Clin Oncol 19:3602-3610, 2001[Abstract/Free Full Text]

3. Grange F, Hedelin G, Joly P, et al: Prognostic factors in primary cutaneous lymphomas other than mycosis fungoides and the Sezary Syndrome: The French Study Group on Cutaneous Lymphomas. Blood 93:3637-3642, 1999[Abstract/Free Full Text]

4. Smith BD, Smith GL, Cooper DL, et al: The cutaneous B-cell lymphoma prognostic index: A novel prognostic index derived from a population based registry. J Clin Oncol 23:3390-3395, 2005[Abstract/Free Full Text]

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wilson, L. D. Articles by Smith, B. D. Search for Related Content PubMed PubMed Citation Articles by Wilson, L. D. Articles by Smith, B. D. Social Bookmarking                            What's this?