10.01.18

A new epigenetic test can already at the time of diagnosis determine if a patient has an aggressive type of lymphoma of the skin, new research from Aarhus University Hospital and Aarhus University in Denmark shows.

Lymphoma of the skin is a rare type of cancer affecting approximately 50 Danes annually. The disease can lead to reddish brown changes and actual tumours in the skin. In approximately one third of the cases, this type of cancer is aggressive and the disease can spread to the blood, the lymph nodes and the internal organs. Aggressive disease causes a poorer survival.

So far, it has not been possible to predict if a patient had an aggressive type of the cancer or not. A new test developed by researchers at Aarhus University Hospital and Aarhus University opens new possibilities for identifying the group of patients who most likely will develop an aggressive type of the disease already at the time of diagnosis.

New test is a significant progress

Around one third of the patients with lymphoma of the skin have the aggressive type of the disease, which may spread to the blood, the lymph nodes and the internal organs. So far, there has been no method to identify those patients and all patients have thus had the same treatment until they showed signs of aggressive disease. The treatment has primarily been local and consisted of e.g. steroids being applied to the skin. Only when the patients show signs of aggressive disease, they receive a more aggressive systemic treatment, including immunotherapy and chemotherapy. 

In a nationwide study in Denmark, the researchers have developed and tested a molecular marker – a so-called epigenetic marker, which can predict the course of disease with a much higher precision at the time when the patient is diagnosed with lymphoma of the skin.

- The new test will make it possible to offer a better follow-up and treatment for patients with lymphoma of the skin, says Lise Lindahl, MD and postdoc at Department of Dermatology, Aarhus University Hospital.

- Patients with a high risk of developing the aggressive type of the disease will get the possibility to have a more efficient treatment at an early point during the course of disease. In the long term, patients with a low risk will have a more mild treatment with fewer side effects.

Facts:

• Lymphoma of the skin is a rare cancer disease affecting approximately 50 Danes annually
• The disease affects all age groups, but is most often diagnosed in the age group 55 to 65 years and it affects men almost twice as often as women  
• The causal factors of the disease are yet unknown
• Lymphoma of the skin is easily mistaken for eczema or other benign skin conditions and often more skin biopsies have to be taken to establish the diagnosis  
• In the early stages of the disease, reddish brown and possibly slightly thickened changes of the skin are seen. The disease can be at this early stage for many years but in approximately one third of the patients, the condition develops to an aggressive and life-threatening disease 
• In the advanced, aggressive stages of the disease, tumours may occur in the skin, larger areas of the skin may be red and possibly associated with stinging and/or itching. The disease may spread to the lymph nodes and internal organs  
• The early stages of the disease are often treated locally with steroids, light therapy and mustard gas. This treatment is often supplemented with tablets, injections and/or radiation therapy in the more advanced stages of the disease  
• In the more advanced stages of the disease it may be necessary to use different systemic drugs including chemotherapy.  

Behind the research result:

Type of study: Translational research  

Collaborators: Søren Besenbacher, Department of Molecular Medicine, Aarhus University Hospital and Professor Niels Ødum and researchers at Department of Immunology and Microbiology, University of Copenhagen.

External financing: LINAK A/S Nordborg, Danish Cancer Society, Novo Nordisk Foundation, Aage Bangs Foundation and the Cancer Foundation.

Conflicts of interest: The test is patented by Aarhus University and University of Copenhagen.

Read the scientific article:

”Prognostic miRNA classifier in early-stage mycosis fungoides: Development and validation in a Danish nationwide study” Blood: http://www.bloodjournal.org/content/early/2017/12/05/blood-2017-06-788950.long?sso-checked=true

Further information:

Lise Lindahl, MD, PhD and postdoc, Department of Dermatology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, e-mail: lise.lindahl@clin.au.dk

Lars Iversen, Professor, Consultant, DMSc, Department of Dermatology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, e-mail: lars.iversen@clin.au.dk, cell: +45 30 91 49 70.