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Giornale Italiano di Dermatologia e Venereologia 2004 June;139(3):231-8

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Mycosis fungoides. A clinico-pathological and biological model of tumour progression

Mori M. ¹, Cappugi P. ¹, Pimpinelli N. ²

¹ Physical Therapy Unit University of Florence Medical School, Florence, Italy 2 Department of Dermatological Sciences University of Florence Medical School, Florence, Italy

Mycosis fungoides (MF) is the most frequent and well known type of cutaneous T-cell lymphoma (CTCL). It is by far a unique model of indolent lymphoproliferative disorder, which slowly progresses through sequential (patch, plaque, and tumour) stages. The mechanisms responsible for the slow, stepwise tumour progression of MF are still to be clarified. Numerous studies in the last years have been performed with the aim to offer an explanation for the particular homing recruitment and retention of CD4+ neoplastic T-cells in the epidermis (so called epidermotropism) in early MF and its loss in more advanced disease, and to investigate deeper the related immune alterations. Some of the hypotheses arisen from the above studies – e.g. the progressively greater imbalance between neoplastic (Th2-type?) and reactive/modulatory T-cells (Th1-type?), and the crucial role of dendritic (antigen-presenting) cells in the induction of a T-cell-mediated apoptosis of neoplastic cells - definitely contributed both to the development and clinical use of new drugs and to a better elucidation of the possible mechanisms of action of established treatment modalities. The plenty of ongoing studies focused on the genomic alterations in MF will probably add powerful insights to the knowledge of its pathomechanims, and will condition the treatment strategies accordingly.