Cutaneous T-cell lymphoma combined with sepsis more common in older Black patients

A greater proportion of patients with cutaneous T-cell lymphoma and sepsis were older, Black and experienced more sepsis episodes compared with patients with sepsis and a different type of non-Hodgkin lymphoma, according to a study.

In addition, more of these patients with sepsis and cutaneous T-cell lymphoma (CTCL) vs. non-CTCL non-Hodgkin lymphoma (NHL) also died or were readmitted to a hospital within 30 days of an inpatient sepsis episode.

“Guidelines for identifying CTCL patients at high risk for sepsis are lacking,” Madeline J. Hooper, BA, visiting predoctoral research fellow at Northwestern Medicine, and colleagues wrote. “Little is known about the clinical characteristics such as the disease-specific features that predispose patients to severe infections or the most common infectious agents themselves that are associated with poor outcomes in CTCL sepsis.”

In this single-institution, two-part retrospective cohort study, researchers compared the demographics and risks of CTCL (n = 97) and non-CTCL NHL (n = 88) patients admitted with sepsis to a general cohort of patients with CTCL (n = 1,094).

Results showed that a greater proportion of patients with CTCL and sepsis predominately identified as Black compared with the non-CTCL NHL and general CTCL cohorts (57% vs. 15% vs. 9%, respectively). Also, Black patients with CTCL and sepsis were older than their non-sepsis counterparts (62 vs. 52 years; P < .0001), whereas white patients with CTCL and sepsis were the same age or younger than their non-sepsis counterparts (52 vs. 59 years).

Data showed that while Black patients with CTCL presented more advanced stages of disease than white patients, there were no racial differences based on clinical stage among those that developed sepsis.

The study also found that patients with CTCL are at a greater risk for sepsis compared with patients with non-CTCL NHL, as a greater proportion experienced short-term sepsis recurrence (14% vs. 1%; P = .0008), hospital readmission (12% vs. 0%; P = .0006) and death (44% vs. 16%; P < .0001).

“Evaluation of racial differences in CTCL remains essential to this research focus,” Hooper and colleagues wrote. “The strategic use of targeted antimicrobial therapies (topical or systemic), plus efforts to repair the skin barrier and reconstitute a healthy cutaneous microbiome could reduce disease burden and modulate the likelihood of superinfection and subsequent sepsis in these patients.”