Will the retinoid revolution change the clinician's approach to cutaneous T-cell lymphoma (CTCL) therapy the way it has changed the approach to acne and psoriasis treatments? Kessler et al1 initially reported a response of CTCL to prolonged high-dose 13-cis-retinoic acid therapy, and in this issue of the Archives, Kessler and colleagues2 extend their earlier experience.
The most successful new therapies for CTCL will exploit the unique immunobiologic features of the malignant cells. Multiagent chemotherapy regimens for other malignancies were developed from advances in the understanding of cell cycling and cell biology. In a similar manner, advances in the understanding of keratinocyte-lymphocyte interactions, lymphocyte clonality, and antineoplastic T-cell activity of therapeutic agents will provide theoretically exploitable inroads for the treatment of CTCL.
Immunophenotyping of CTCL infiltrates has shown the lymphocytes to be helper/inducer T cells.3 In an attempt to focus on these cells, agents
Heald PW, Edelson RL. New Therapies for Cutaneous T-Cell Lymphoma. Arch Dermatol. 1987;123(2):189-191. doi:10.1001/archderm.1987.01660260059012