A case-control study of clinicopathologic features, prognosis, and therapeutic responses in patients with granulomatous mycosis fungoides - 17/08/13

Abstract |
Background |
Granulomatous mycosis fungoides (GMF) is an uncommon variant of mycosis fungoides (MF).
Objective |
We sought to analyze the relative frequency, clinicopathologic characteristics, prognosis, and therapeutic responses of GMF.
Methods |
We conducted a retrospective case-control study of patients with GMF and age- and stage-matched patients with classic MF between 1981 and 2012.
Results |
A total of 27 patients with GMF were identified, representing 6.3% of all patients with MF at our center. Skin manifestations were similar to classic MF having an atypical lichenoid CD4+ CD8− lymphocytic infiltrate with interstitial histiocytes and/or perivascular granulomas with giant cells. Fewer patients with GMF achieved a partial response or complete response with topical (57% vs 83%; P = .002) or ultraviolet light (62% vs 90%; P = .006) therapy. The 5- and 10-year progression-free survival rates were significantly lower in patients with GMF (59% and 33%) compared with patients with classic MF (84% and 56%; P = .02), but overall survival was similar between groups (86% and 72% vs 85% and 85%; P = .54).
Limitations |
The retrospective methodology may underestimate the frequency of GMF. The median follow-up time may be too short to detect possible differences in overall survival.
Conclusion |
More frequent disease progression and poorer response to skin-directed therapies were observed in patients with GMF. Our findings may be helpful in selecting the most appropriate treatment for these patients.
Il testo completo di questo articolo è disponibile in PDF.Key words : cutaneous T-cell lymphoma, disease progression, granulomatous mycosis fungoides, histopathology, incidence, outcome, treatment response
Abbreviations used : CR, EORTC, GMF, ISCL, LCT, MF, OS, PFS, PR, TCR, Th
Mappa
| The first 2 authors contributed equally to this article. |
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| Funding sources: None. |
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| Disclosure: Dr Horwitz has received research grants from Celgene, Allos, Seattle Gen, Infinity Pharmaceuticals, and Kyowa Hakko Kirin. He has consulted for Celgene, Allos, Seattle Gen, Bristol-Myers Squibb, Genzyme, Kyowa Hakko Kirin Pharma, and Johnson & Johnson. Ms Li, and Drs Pulitzer, Myskowski, Dusza, Moskowitz, and Querfeld have no conflicts of interest to declare. |
Vol 69 - N° 3
P. 366 - settembre 2013 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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