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. 2020 Aug;83(2):430-439.
doi: 10.1016/j.jaad.2019.08.073. Epub 2019 Sep 6.

Outcomes and prognostic factors in African American and black patients with mycosis fungoides/Sézary syndrome: Retrospective analysis of 157 patients from a referral cancer center

Shamir Geller  1 , Emily Lebowitz  2 , Melissa P Pulitzer  3 , Steven M Horwitz  4 , Alison J Moskowitz  4 , Steve Dusza  5 , Patricia L Myskowski  6
Affiliations

Outcomes and prognostic factors in African American and black patients with mycosis fungoides/Sézary syndrome: Retrospective analysis of 157 patients from a referral cancer center

Shamir Geller et al. J Am Acad Dermatol. 2020 Aug.

Abstract

Background: The prevalence of mycosis fungoides/Sézary syndrome (MF/SS) is higher in the black population than in the white population in the United States and worse outcomes have been observed in black patients.

Objective: To describe the outcomes and to identify prognostic factors in African American and black patients with MF/SS.

Methods: Clinical features and follow-up data were analyzed in 157 self-identified African American or black patients seen during 1994-2018.

Results: We included 122 patients with early stage MF and 35 patients with advanced-stage disease (median follow-up of 25 months). Overall, >80% of the patients who died from disease or progressed had erythema or hyperpigmentation without hypopigmentation. Patients with hypopigmentation, either as the sole manifestation or in combination with other lesions, had better overall survival (P = .002) and progression-free survival (P = .014). Clinical stage, TNMB classification, plaque disease, and elevated serum lactate dehydrogenase were also significantly associated with outcomes. Demographic and socioeconomic parameters were not associated with prognosis.

Limitations: A retrospective study at a single cancer center.

Conclusion: MF/SS manifestations and outcomes in African American and black patients are heterogeneous. Demographic and socioeconomic factors do not seem to have a prognostic role, while clinical characteristics might help in the stratification of risk of progression and shorter survival, allowing for individually tailored therapeutic interventions.

Keywords: African American; MF; cutaneous lymphoma; hyperpigmented MF; hypopigmented MF; racial disparity; skin of color; survival analysis.

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Conflict of interest statement

Conflict of interest disclosures: Steve M. Horwitz has received both research funding/grant support and honoraria/consulting fees from ADCT Therapeutics, Aileron, Forty-Seven Infinity/Verastem Kyowa-Hakka-Kirin, Millennium / Takeda and Seattle Genetics; Research/grant support from Celgene and Trillium; and honoraria consulting fees from Affimed, Angimmune, Beigene, Corvus, Innate Pharma, Kura, Merck, Miragen, Mundipharma, Portola, and Syros Pharmaceutical. Alison J. Moskowitz received honoraria from Seattle Genetics; Consulting or advisory role for Seattle Genetics, Kyowa Hakko Kirin Pharma, Miragen Therapeutics, Takeda Pharmaceuticals, ADC Therapeutics, Cell Medica, Bristol-Myers Squibb, Erytech PharmaResearch; and received funding from Incyte (Inst), Seattle Genetics (Inst) Merck (Inst), Bristol-Myers Squibb (Inst). All other authors have no conflict of interest to declare.

Figures

Figure 1.
Figure 1.
Kaplan-Meier Plots of Progression Free Survival from presentation in Black Patients with Early-stage Mycosis Fungoides (A) Hypopigmented lesions, Log rank = 0.013 (B) Plaques, Log rank = 0.038 (C) Lymph Node involvement, Log rank = 0.02
Figure 1.
Figure 1.
Kaplan-Meier Plots of Progression Free Survival from presentation in Black Patients with Early-stage Mycosis Fungoides (A) Hypopigmented lesions, Log rank = 0.013 (B) Plaques, Log rank = 0.038 (C) Lymph Node involvement, Log rank = 0.02
Figure 1.
Figure 1.
Kaplan-Meier Plots of Progression Free Survival from presentation in Black Patients with Early-stage Mycosis Fungoides (A) Hypopigmented lesions, Log rank = 0.013 (B) Plaques, Log rank = 0.038 (C) Lymph Node involvement, Log rank = 0.02
See this image and copyright information in PMC

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