Complete durable remission of a fulminant primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma after autologous and allogeneic hematopoietic stem cell transplantation

CHOEP: chemotherapy with cyclophosphamide doxorubicin, etoposide, vincristine, and prednisone CTCL: cutaneous T-cell lymphoma HLA: human leukocyte antigen HSCT: hematopoietic stem cell transplantation LyP: lymphomatoid papulosis INTRODUCTION We report a case of a fulminant cutaneous cytotoxic T-cell lymphoma nonresponsive to chemotherapy but showing durable complete response to a fast sequence of autologous and allogeneic hematopoietic stem-cell transplantation (HSCT). mSWAT: modified Severity Weighted Assessment Tool CASE REPORT A 47-year-oldmanwas admitted to our department with a 4-month history of initially slowly progressive disseminated erythematous plaques, of which several had ulcerated and were covered by a black crust (Fig 1). Mucous membranes were not involved (modified Severity Weighted Assessment Tool [mSWAT ] score, 88.5). Previous treatments with topical steroids were ineffective. Findings from histologic analysis were compatible with lymphomatoid papulosis (LyP) type D. Two weeks later, he was re-admitted because of enlarged ulcerated plaques (no B symptoms, Eastern Cooperative Oncology Group performance status, 2). Further analysis of the previous and a new biopsy found histopathologic and immunophenotypic features of a cytotoxic cutaneous T-cell lymphoma (CTCL), ie, infiltration of hyperchromatic