This protocol applies to patients with primary cutaneous anaplastic large cell lymphoma (pcALCL) who present with multifocal skin lesions. The extent and pattern of cutaneous involvement in this setting is a central factor in determining the appropriate management pathway.
Multifocal skin lesion involvement represents a distinct disease presentation in pcALCL that guides clinical decision-making and influences the choice among available treatment options.
In cases where systemic escalation is warranted, the protocol includes a multi-agent chemotherapy approach. The specific agents, eligibility criteria, and sequencing are reserved for the full protocol.
Patients presenting with multifocal skin lesions can best be treated with low-dose MTX, as in LyP [IV, A], or with RT [IV, A] in the case of only a few lesions.
Multi-agent ChT is only indicated in patients presenting with or developing extracutaneous disease and in rare patients with rapidly progressive skin disease.