Background: There is no consensus on the treatment of multifocal primary cutaneous anaplastic large cell lymphoma (C-ALCL). Radiotherapy (RT) and methotrexate (MTX) are the current treatment... Show moreBackground: There is no consensus on the treatment of multifocal primary cutaneous anaplastic large cell lymphoma (C-ALCL). Radiotherapy (RT) and methotrexate (MTX) are the current treatment options, but their efficacy is unknown. Recently, targeted therapies showed promising results in C-ALCL, and may therefore be an attractive first choice of treatment. Objectives: To assess the efficacy of conventional treatment strategies for patients with multifocal C-ALCL, and to define which patients may require novel targeted therapies.Methods: In this multicenter study, treatment was evaluated in patients initially presenting (n=24) or relapsing with multifocal C-ALCL (n=17; 23 relapses). Distinction was made between cases with ≤ 5 (n=36) and >5 lesions (n=11).Results: Treatments most commonly used were radiotherapy (n=21), systemic chemotherapy (n=9) and low-dose methotrexate (MTX; n=7) with complete response rates of 100%, 78% and 43%, respectively, and an overall response rate of 100%, 100%, and 57%, respectively. Four patients showed a complete spontaneous regression. Sixteen of 24 patients (67%) first presenting with multifocal C-ALCL relapsed, including all five patients initially treated with CHOP. Compared with patients presenting with 2-5 skin lesions, patients presenting with >5 lesions had a higher chance of developing extracutaneous relapse (56 vs 20%) and more often died of lymphoma (44% vs 7%). Conclusion: Patients with ≤5 lesions should be treated with low-dose RT (2x4 Gy). Maintenance low-dose MTX (20 mg/week) is a suitable option in patients with >5 lesions. Targeted therapies may be considered in rare patients refractory to MTX or patients developing extracutaneous disease. Show less
This guidebook is the result of a two-year Leonardo Partnership project titled “Social and Emotional Learning in Vocational Education” (SELVET). This was supported by the European Commission’s... Show moreThis guidebook is the result of a two-year Leonardo Partnership project titled “Social and Emotional Learning in Vocational Education” (SELVET). This was supported by the European Commission’s Lifelong Learning Programme. Non-cognitive abilities – such as persistence, motivation, emotional stability, and social skills – are considered to be as important, if not more so, than cognitive capabilities when determining one’s success in life, and in working life in particular. One example of the way these competences can be learnt is through Social and Emotional Learning (SEL) programmes. The SELVET Partnership wished to explore the application of SEL interventions within each partner country and how their learning could inform the application of SEL interventions in Vocational Education and Training (VET). The purpose of our guidebook is to give an overview of the concept of SEL and its application within partner countries, to raise awareness of its importance, and to provide a rationale and argument for inclusion of such programmes in VET. Our main target audience includes school directors, principals, and teachers, as well as decision-makers and policy-developers within vocational education. However we also anticipate that it will be of interest to education-providers from other spheres as well. Show less
