Clinical picture, therapy, and follow-up for each patient
| Case no. . | Age (median 64 y)/sex ratio (5:2 male/female) . | Sites of involvement at diagnosis . | Initial treatment . | Response . | Relapse, months . | Sites of relapse . | Therapy at relapse . | Follow-up, months . | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Skin (n = 21) . | BM (n =10) . | Peripheral blood (n =9) . | Lymph node (n =5) . | Other (n =2) . | ||||||||
| 1 | 64/M | Mu | + | + | − | − | ALL-type* | CR | 11 | S/BM/B | CHT | DOD 23 |
| 2 | 83/M | D | + | + | + | − | None | — | — | — | — | DOD 3 |
| 3 | 38/M | Mu | + | − | − | − | SCT | CR | 17 | S/BM/B/Ly | CHT | DOD 20 |
| 4 | 67/F | D | − | − | − | − | ALL-type* | PR | 5 | S | CHT | AWD 11 |
| 5 | 84/F | D | − | − | − | − | mCHT† | PR | 4 | B | — | DOD 6 |
| 6 | 64/M | D | + | + | − | − | ALL-type‡ | CR | 10 | S/BM/B | CHT | DOD 26 |
| 7 | 19/M | Mu | − | − | − | − | NHL-type§ | CR | 36 | S | SCT | AWD 72 |
| 8 | 62/M | Mu | + | + | + | − | ALL-type* | CR | — | — | — | ADF 13 |
| 9 | 61/M | Mu | − | − | − | − | NHL-type§ | CR | 30 | S/BM/B/Ly | CHT | DOD 35 |
| 10 | 83/M | D | + | + | − | MALT | NHL-type§ | PR | 8 | S/BM/B/O | CHT | DOD 10 |
| 11 | 40/M | L | − | − | − | − | mCHT† + RT | PR | 20 | BM/B | CHT | DOD 30 |
| 12 | 60/M | D | − | − | + | − | SCT | CR | — | — | — | DTR 60 |
| 13 | 76/M | L | − | − | − | − | RT | CR | 8 | BM | CHT | AWD 13 |
| 14 | 9/F | D | + | + | − | − | ALL-type* | CR | — | — | — | ADF 12 |
| 15 | 58/M | D | − | − | − | − | ALL-type* | CR | — | — | — | ADF 28 |
| 16 | 79/M | L | − | − | − | − | RT | CR | — | — | — | ADF 14 |
| 17 | 75/F | D | − | − | − | − | ALL-type* | CR | — | — | — | ADF 8 |
| 18 | 39/F | L | − | − | − | − | ALL-type*‖ | CR | — | — | — | DTR 12 |
| 19 | 66/F | Mu | + | + | − | − | NHL-type§ | PR | 5 | S/BM/B/O | CHT | DOD 20 |
| 20 | 64/M | D | + | + | + | MALT | ALL-type* | PR | 4 | S/B | SCT | DOD 12 |
| 21 | 83/M | L | + | + | + | − | None | — | — | — | — | DOD 1 |
| Case no. . | Age (median 64 y)/sex ratio (5:2 male/female) . | Sites of involvement at diagnosis . | Initial treatment . | Response . | Relapse, months . | Sites of relapse . | Therapy at relapse . | Follow-up, months . | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Skin (n = 21) . | BM (n =10) . | Peripheral blood (n =9) . | Lymph node (n =5) . | Other (n =2) . | ||||||||
| 1 | 64/M | Mu | + | + | − | − | ALL-type* | CR | 11 | S/BM/B | CHT | DOD 23 |
| 2 | 83/M | D | + | + | + | − | None | — | — | — | — | DOD 3 |
| 3 | 38/M | Mu | + | − | − | − | SCT | CR | 17 | S/BM/B/Ly | CHT | DOD 20 |
| 4 | 67/F | D | − | − | − | − | ALL-type* | PR | 5 | S | CHT | AWD 11 |
| 5 | 84/F | D | − | − | − | − | mCHT† | PR | 4 | B | — | DOD 6 |
| 6 | 64/M | D | + | + | − | − | ALL-type‡ | CR | 10 | S/BM/B | CHT | DOD 26 |
| 7 | 19/M | Mu | − | − | − | − | NHL-type§ | CR | 36 | S | SCT | AWD 72 |
| 8 | 62/M | Mu | + | + | + | − | ALL-type* | CR | — | — | — | ADF 13 |
| 9 | 61/M | Mu | − | − | − | − | NHL-type§ | CR | 30 | S/BM/B/Ly | CHT | DOD 35 |
| 10 | 83/M | D | + | + | − | MALT | NHL-type§ | PR | 8 | S/BM/B/O | CHT | DOD 10 |
| 11 | 40/M | L | − | − | − | − | mCHT† + RT | PR | 20 | BM/B | CHT | DOD 30 |
| 12 | 60/M | D | − | − | + | − | SCT | CR | — | — | — | DTR 60 |
| 13 | 76/M | L | − | − | − | − | RT | CR | 8 | BM | CHT | AWD 13 |
| 14 | 9/F | D | + | + | − | − | ALL-type* | CR | — | — | — | ADF 12 |
| 15 | 58/M | D | − | − | − | − | ALL-type* | CR | — | — | — | ADF 28 |
| 16 | 79/M | L | − | − | − | − | RT | CR | — | — | — | ADF 14 |
| 17 | 75/F | D | − | − | − | − | ALL-type* | CR | — | — | — | ADF 8 |
| 18 | 39/F | L | − | − | − | − | ALL-type*‖ | CR | — | — | — | DTR 12 |
| 19 | 66/F | Mu | + | + | − | − | NHL-type§ | PR | 5 | S/BM/B/O | CHT | DOD 20 |
| 20 | 64/M | D | + | + | + | MALT | ALL-type* | PR | 4 | S/B | SCT | DOD 12 |
| 21 | 83/M | L | + | + | + | − | None | — | — | — | — | DOD 1 |
BM indicates bone marrow; Mu, multiple noncontiguous skin lesions; D, diffuse skin involvement; L, localized skin disease; Ly, lymph node; MALT, mucosa-associated lymphoid tissue; O, other; B, peripheral blood; ALL, acute lymphoblastic leukemia; SCT, allogeneic stem cell transplantation; mCHT, monochemotherapy; NHL, non-Hodgkin lymphoma; RT, radiotherapy; CR, complete remission; —, not available; PR, partial remission; S, skin; CHT, chemotherapy; DOD, dead of disease; AWD, alive with disease; ADF, alive disease-free; and DTR, death therapy-related.
Hyper-CVAD regimen (hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, alternating with high-dose methotrexate and cytarabine).
Hydroxyurea.
IVA regimen (ifosfamide, vincristine, actinomycin-D).
CHOP regimen (cyclophosphamide, doxorubicin, vincristine, prednisolone).
This patient had skin-limited disease at diagnosis, but she refused treatment until 8 months later when bone marrow involvement developed.