The Impact of a Multidisciplinary Clinic on Diagnosis and Management of Patients with Cutaneous T-cell Lymphoma

Multidisciplinary clinics (MDCs) have been shown to improve patient outcomes and reduce disease-specific mortality. This study aims to evaluate the impact of a MDS clinic on diagnosis, management, and clinical outcomes of patients diagnosed with CTCL. A retrospective cohort analysis of a CTCL MDS clinic was conducted between January 2018 to August 2023 at a large academic institution. Patients diagnosed with CTCL with at least one visit to the CTCL MDS clinic were included. Medical records were reviewed for patient demographics, diagnosis change, treatment management, survival outcomes, and clinicopathologic disease characteristics at 6-month intervals. A descriptive analysis was performed. 55 patients were identified (mean age 62.7; 58.1% male; 89.1% White). 80.0% of patients were diagnosed with CTCL, however, 78% were previously diagnosed with other dermatologic conditions. At initial presentation, 20% had a change in diagnosis with 12.7% changing to a benign dermatologic condition. Only 9% of patients had staging prior to initial visit, while majority (62%) received initial staging evaluation during their first visit. At the initial visit, 50.2% had an escalation of treatment, mainly of skin-directed therapy (36.4%). Over 6-month intervals, majority of patients had an escalation of treatment (21.1–51.1%). The modified severity weighted assessment tool (mSWAT) decreased over time (41.8 to 3.5), with many achieving stable disease (18.4–50%). MDS management is highly recommended for patients with CTCL. This study further highlights the important role of a CTCL MDS clinic, specifically in establishing accurate diagnoses, managing appropriate treatments, and stabilizing disease progression.