Epidemiology and prognostic factors for mycosis fungoides and Sézary syndrome in a multi‐ethnic Asian cohort: a 12‐year review

Abstract

Background Limited information exists regarding survival of Asian patients with mycosis fungoides (MF) and Sézary syndrome (SS). Objective To evaluate the epidemiology, outcome and prognostic factors of these patients. Methods A retrospective review of MF/SS cases diagnosed from 2000 to 2011 at a tertiary referral dermatology centre in Singapore was performed. Results Of 246 patients, 63% were male and the median age at diagnosis was 49 years. 73.2% were Chinese, 12.6% Indian, 6.9% Malay and 7.3% Caucasian. A total of 239 patients (97.2%) had MF and seven had SS. Median follow‐up duration was 6.3 years, and median duration of symptoms at diagnosis was 13 months. For patients with MF, the majority had early disease (92.8% stage IA–IIA). 3.8% were stage IIB, 1.7% stage III and 1.7% stage IV. Complete response to treatment occurred in 78.2%, partial response in 9.6%, persistent but non‐progressive disease in 10.0% and disease progression in 4.1% of patients. Large cell transformation occurred in 4.1% of patients. Mean overall survival during this study was 12.7 years, with death occurring in 2.5% of patients (all ≥stage IIB at diagnosis). For patients with SS, 71.4% presented with stage IVA disease, 28.6% stage IVB. Complete response to treatment occurred in 14.2%, persistent but non‐progressive disease in 28.6% and disease progression in 57.2% of patients. Mean overall survival was 3.3 years within this study, with death occurring in 42.9% of SS patients. Prognostic factors associated with favourable recurrence‐free survival were male gender (P = 0.008), early disease stage (T1) at diagnosis (P < 0.001) and absence of maintenance treatment after remission (P = 0.01). Conclusion Compared to Caucasian and East Asian cohorts, MF in South‐East Asians was diagnosed at a younger age and associated with lower mortality, largely due to greater prevalence of hypopigmented MF.

Clinical characteristics of primary cutaneous lymphoma: analysis from two centres in China

“…We also observed from one study that perhaps Asian patients with MF were younger than white, black and mixed‐race patients . This could also be supported by results from a retrospective review in which 73·2% of cases were Chinese and median age at diagnosis was 49 years . Furthermore, we also observed an age difference between early ( n = 457) and advanced ( n = 99) MF stages in our data.…”

“…3 This could also be supported by results from a retrospective review in which 73Á2% of cases were Chinese and median age at diagnosis was 49 years. 4 Furthermore, we also observed an age difference between early (n = 457) and advanced (n = 99) MF stages in our data. Compared with 57 years in early stage and 64Á5 years in advanced stage demonstrated by Scarisbrick et al, 5,6 our patients were on average younger than theirs (41 years in early stage and 48 years in advanced stage), although our study has only 99 advanced-stage patients, so more cases are needed to verify this.…”

The different faces of mycosis fungoides: results of a single‐center study

“…Recent literature has shown similar clinical‐epidemiological patterns of MF between fair‐ and dark‐skinned individuals. Compared with Caucasians, however, MF in South‐East Asians tends to be diagnosed at a younger age, mainly because of the greater prevalence of hypopigmented MF (HMF), especially in the juvenile setting . In line with this finding, patients in our cohort were in general older at the time of MF diagnosis compared to Asian cohorts where the mean age at diagnosis was 49.9 years .…”

Comorbidities in Mycosis Fungoides and Racial Differences in Co-Existent Lymphomatoid Papulosis: A Cross-Sectional Study of 580 Patients in an Urban Tertiary Care Center

“…In line with the literature, the majority (64.8%) of our study group were aged between 50 and 79 years [2,3]. However, in contrast to previous studies the number of females in our MF cohort outnumbered the males (51% vs. 49%) [2,3,[14][15][16]. Concordant with earlier observations, we found that Caucasians were most commonly affected, constituting 56.1% of our patient cohort [2,8,17].…”