2024 update of the article: Primary cutaneous lymphomas. Diagnostic and therapeutic guidelines of the Polish Dermatological Society (PTD) and Polish Lymphoma Research Group (PLRG)

Dear Editor,
In light of the changes to drug reimbursement and availability that occurred in Poland in 2024, we are submitting revised versions of Table 9 and Figure 10 from the Guidelines published in Dermatol Rev/Przegl Dermatol 2023, 110, 647-674 [1].
The above-mentioned table and figure provide details on medications used in the treatment of mycosis fungoides and Sézary syndrome. The revisions apply to the following drugs and therapies:
– PUVA phototherapy (no availability of Oxsoralen on the Polish market);
– peginterferon a-2a (referred to as IFN-a in the guidelines and tables); peginterferon a-2a is currently unavailable, likely due to the discontinuation of production; an application for reimbursement of ropeginterferon a-2b has been submitted by the National Consultant in Hematology, but as of 9 July 2024, no decision has been made;
– mogamulizumab (from 1 July 2024, the drug is available under the drug program for the treatment of cutaneous T-cell lymphomas (B.66) to patients with mycosis fungoides at stage IB or higher, and Sézary syndrome confirmed by cytometric testing, following the failure of at least one line of systemic treatment);
– bexarotene, brentuximab vedotin and mogamulizumab – in drug program B.66 available in monotherapy (previously there was no provision for monotherapy).

It needs to be noted that:
– brentuximab vedotin – not available in the drug program for patients with Sézary syndrome;
– methotrexate – no reimbursement for the treatment of cutaneous T-cell lymphomas (tablets are affordable, but the injectable medication is not);
– mechlorethamine for topical treatment of initial stages of mycosis fungoides – still no reimbursement (available under RDTL);
– extracorporeal photopheresis (ECP) – not reimbursed in Sézary syndrome and mycosis fungoides; however, ECP is reimbursed in GVHD (graft versus host disease) which may occur after allo-HSCT (allogeneic hematopoietic cell transplantation) in primary cutaneous T-cell lymphomas; consequently, ECP is not used (as intended by the originator of the method) in patients with mycosis fungoides with blood involvement and Sézary syndrome treated without allo-HSCT.
This updated information enables the implementation of diagnostic and therapeutic guidelines for primary cutaneous lymphomas that align with current medical knowledge and available resources.

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