Optimizing Care and Compliance for the Treatment of Mycosis Fungoides Cutaneous T-Cell Lymphoma With Mechlorethamine Gel.

BACKGROUND: Mycosis fungoides is the most common form of cutaneous T-cell lymphoma (MF-CTCL). Quality nursing care is necessary for effective diagnosis and treatment of patients with MF-CTCL. Early-stage MF-CTCL (stages Ia and Ib) is most often managed in both dermatology and multidisciplinary settings. These stages can be effectively controlled by skin-directed therapies such as mechlorethamine gel (Valchlor®). Topical mechlorethamine has been used since the 1940s as an alkylating agent; however, compounded formulas have disadvantages that limit patient compliance. In contrast, newly approved mechlorethamine gel has demonstrated an efficacious and well-tolerated profile that has longer stability and is quicker to dry than its compounded counterpart. OBJECTIVES: This article aims to provide recommendations for optimal nursing care of patients who have been diagnosed with stage Ia or Ib MF-CTCL. METHODS: Four real-world patient cases are examined, along with practical considerations for the use of mechlorethamine gel to treat patients with MF-CTCL. FINDINGS: Nurses can promote patient adherence through specific interventions and strategies, such as education about mechlorethamine gel, its mechanism of action, and safety and efficacy, as well as connecting patients with patient assistance programs or other supportive services.

Cutaneous T-cell lymphoma: overview and nursing perspectives.

Cutaneous T-cell lymphoma (CTCL) is an uncommon and complex malignancy of the immune system with a wide range of clinical presentations primarily involving the skin. An extensive menu of skin-directed and/or systemic treatment options exists. Best practices in management involve multidisciplinary collaboration. Nursing care for patients who have CTCL is a critical component in the successful management of the disease and requires special attention to the patient's physical, emotional, and spiritual needs. Nurses can make a significant impact by being accessible, offering emotional support, demonstrating advocacy, and providing ongoing education for the patient and family.

Transformación de la micosis fungoide/síndrome de Sézary a linfoma de células grandes / Transformation of mycosis fungoides/Sézary syndrome to large cell lymphoma

Introducción: la micosis fungoide (MF) y el síndrome de Sézary (SS) son linfomas cutáneos caracterizados por una proliferación de linfocitos T de pequeño o mediano tamaño. Algunos pacientes con MF/SS desarrollan una transformación a linfoma de células grandes (LCG).Objetivo: estudiar las características clinicopatológicas e inmunohistoquímicas, así como el pronóstico de seis casos de MF/SS que en un grupo de 50 pacientes con esa enfermedad evolucionaron a LCG. Material y métodos: aceptamos como casos transformados a LCG aquellos en los cuales las células grandes superaban el 25% del infiltrado o formaban nódulos microscópicos. Resultados: la localización inicial del LCG fue en la piel en cuatro casos, manifestándose en forma de tumores cutáneos; los dos casos restantes se presentaron con clínica extracutánea. Los hallazgos anatomopatológicos fueron característicos de LCG. Desde el punto de vista inmunohistoquímico todos los casos expresaron antígenos linfoides de línea T; la inmunotinción con CD30 fue positiva en tres; un porcentaje alto de células tumorales mostraron positividad para el antígeno de proliferación nuclear Ki-67. Todos los pacientes fallecieron en relación directa con su linfoma y la supervivencia mediana desde el diagnóstico de la MF/SS fue de 8 meses, mientras que fue de 114 meses en los 44 casos restantes. Conclusión: la transformación de la MF/SS a LCG se asocia a un comportamiento agresivo de la enfermedad, con supervivencia baja (AU)

A brief review of the pathophysiology and treatment of cutaneous T-cell lymphoma "mycosis fungoides".

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. It represents a spectrum of disorders with preferential involvement of the skin and, after a period of time, may progress to involve lymph nodes, peripheral blood and/or visceral organs. MF progresses in three clinical phases: the premycotic, mycotic and tumor stages. Each stage has different characteristics and goals for treatment. Treatment such as chemotherapy and radiotherapy in the earlier stages is more effective and may be curative, while treatment in the last stage is less effective and the intent is to alleviate symptoms. The case study illustrates topical treatment using sheet hydrogel to absorb exudate, contain odor and reduce pain upon dressing removal for a patient in the tumor stage of MF.

The role of total skin electron beam radiation therapy in the management of mycosis fungoides.

Total skin electron therapy is a complex method of delivering superficial radiation therapy to the entire skin surface. It is an effective means of treating cutaneous malignancies which involve large surface areas of the skin. Mycosis fungoides is the most common malignancy treated in this manner. Understanding the rational and technique of total skin electron beam therapy, the characteristics of mycosis fungoides, and nursing interventions for related patient problems will enable dermatology nurses to better educate patients afflicted with MF who may be undergoing or considering radiation therapy.

Mycosis fungoides: a case study and nursing implications.

Mycosis fungoides is a rare and rapidly progressive form of cutaneous T-cell lymphoma. This article provides an overview of the disease process, as well as a case study to illustrate the complex nursing care of these clients.