Cutaneous T-cell lymphoma (CTCL) is a rare disease that primarily affects people over age 60. It is even rarer in children and is diagnosed in only 100 to 200 children each year in the United States. Nearly 90 percent of these children have early-stage disease, while a few of them are diagnosed with advanced disease that requires a more aggressive approach. Unfortunately, due to its rarity, parents find that most centers have no experience treating pediatric CTCL.
NewYork-Presbyterian/Columbia has created a dedicated Pediatric Cutaneous Lymphoma Program to provide multidisciplinary care for these children. Led by Larisa Geskin, MD — a dermatologic oncologist and world leader in CTCL who was recruited to the hospital from the University of Pittsburgh in January 2014 — the care team includes pediatric dermatologists Kimberly Morel, MD, Maria Garzon, MD, and Christine Lauren, MD; pediatric oncologist Maria Luisa Sulis, MD; pathologists and dermatopathologists; and bone marrow transplantation experts. “This is such a unique cancer, and ours is the only comprehensive multidisciplinary pediatric cutaneous lymphoma center in the world,” Dr. Geskin notes.
Because CTCL cannot be cured and will last for the patient’s lifetime, the team takes a personalized and measured approach to treatment. Children with early-stage disease receive phototherapy and topical treatments, while those with systemic CTCL may initially undergo chemotherapy while waiting for a bone marrow transplant. Those who are matched with a bone marrow donor can undergo the procedure at NYP/Morgan Stanley Children’s.
Dr. Geskin and her colleagues are also conducting research to further the understanding of pediatric CTCL. They are collaborating on an International Pediatric CTCL Registry and analyzing skin tissue, blood, and urine biomarkers that may predict a child’s prognosis. Says Dr. Geskin, “This information will help us learn which patients we need to treat aggressively and which can get by with conservative therapies.”