Chemotherapy in cutaneous T-cell lymphoma

Which and when aggressive treatment in cutaneous T-cell lymphoma (CTCL)? When approaching the topic of chemotherapy in different subtypes of CTCL,1 the first issue to be made clear is the target of this type of treatment. The use of systemic chemotherapy as a first line treatment should be restricted with few exceptions to advanced/aggressive forms of CTCL: advanced mycosis fungoides (MF, stage IIB-IV), Sezary syndrome (SS), primary cutaneous CD30+ anaplastic large cell lymphoma with disseminated lesions, subcutaneous panniculitis-like T-cell lymphoma with progressive lesions, and peripheral T-cell lymphoma, unspecified.