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Journal of the American Academy of Dermatology
Volume 72, n° 2
pages 276-285 (février 2015)
Doi : 10.1016/j.jaad.2014.10.019
accepted : 15 October 2014
Original Articles

Clinical characteristics, prognostic factors, and survival of 393 patients with mycosis fungoides and Sézary syndrome in the southeastern United States: A single-institution cohort
 

Megan Desai, MD a, Shuling Liu, MA b, Sareeta Parker, MD a, c,
a Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia 
b Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia 
c Grady Health System, Atlanta, Georgia 

Correspondence to: Sareeta Parker, MD, Department of Dermatology, Emory Clinic, 1525 Clifton Rd NE, Atlanta, GA 30322.
Abstract
Background

Limited data exist on patients with mycosis fungoides (MF) and Sézary syndrome (SS) from the southeastern United States, a region with a high proportion of African Americans (AA).

Objectives

We sought to determine clinical characteristics, prognostic factors, and survival of patients with MF/SS in a southeastern US cohort, compare with other cohorts, and validate proposed revisions in MF/SS staging.

Methods

This was a retrospective chart review of patients from an academic dermatology referral center (Atlanta, GA) from 1998 to 2013. Kaplan-Meier estimates were calculated for overall survival, disease-specific survival, and progression; univariate and multivariate Cox proportional hazard models were used for assessment of prognostic variables.

Results

Of 393 patients, 55.2% were white, 43.3% AA, and 1.5% other; 52.7% were male and 47.3% female (ratio 1.1:1). Mean age was 53.6 years; mean age among AA was 48.9 years. In all, 19.6% died of disease; 21.9% experienced disease progression. Advanced TNMB classification, presence of a circulating clone without phenotypic evidence of blood involvement, and older age were predictors of poor disease-specific survival in the multivariate analysis, whereas AA race was not.

Limitations

This study was from a single academic center.

Conclusions

Outcomes of our patients generally paralleled those of other geographic regions. MF/SS may affect younger patients and more women than previously recognized, particularly among AA. Survival among AA may be more favorable than that observed in prior reports. Our data support the validity of the staging criteria revisions for MF/SS.

The full text of this article is available in PDF format.

Key words : African American, cutaneous T-cell lymphoma, mycosis fungoides, prognosis, survival

Abbreviations used : AA, CTCL, DSS, EORTC, ISCL, MF, OS, PFS, SS



 Funding sources: None.
 Conflicts of interest: Dr Parker was a principal investigator on a Valeant Pharmaceuticals–sponsored multicenter, randomized, open-label, phase-IV study to assess the efficacy, tolerability, and safety of 2 initial dose levels of bexarotene capsules in patients with refractory cutaneous T-cell lymphoma; no direct financial support was received and this was unrelated to the current report. Dr Desai and Ms Liu have no conflicts of interest to declare.
 Reprints not available from the authors.



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