Asian patients may experience earlier mycosis fungoides diagnosis, better outcomes

Key takeaways:

• The median age for mycosis fungoides diagnosis was 46 years in this study of patients in China.
• Five-year overall survival was 82.2% with disease-specific survival of 83.5%.

Asian patients are often diagnosed with mycosis fungoides at a younger age compared with other races and therefore may have higher overall survival rates, according to a study.

“Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), accounting for nearly 50% of all primary cutaneous lymphomas,” Zhuojing Chen, MD, of the department of dermatology and venereology at Peking University First Hospital, and colleagues wrote. “As an indolent disease, most patients with MF are diagnosed at an early stage, characterized by a slow progression over years, and a favorable prognosis. However, 9% to 34% of patients progress to advanced stages that are associated [with] increased mortality. Understanding prognostic factors and survival statistics of MF will assist in the improved management of MF by identifying patients at high risk of disease progression and its associated mortality.”

This retrospective study included 461 patients with MF who received treatment for skin lymphoma at a single center in China. Clinical presentation, treatment outcome and laboratory test result data were collected every 1 to 3 months for those with advanced disease and every 3 to 6 months for those in remission or with mild disease.

Overall 5-year survival rate for these patients was 82.2%, with disease-specific 5-year survival at 83.5% and progression-free 5-year survival at 79.6%.

The median age for diagnosis was 46 years. A meta-analysis of 1,502 patients in the United Kingdom showed a median age of diagnosis of 54 years, making the Chinese cohort significantly younger.

Additionally, the 5-year overall survival in the U.K. cohort — in which patients were mostly white — of 75% was significantly lower than the overall survival of 82.2% in the Chinese group. However, the discrepancy was corrected when adjusted for age.

When compared with other cohort studies with a majority Asian population, the results were similar.

“Our data support a possible association between younger age at MF diagnosis and more favorable outcomes among Asian patients,” the authors wrote.

The study’s limitations included its single center nature, although being a tertiary referral center for skin lymphoma, the patient population did include representation from 26 of China’s 34 provinces. Additionally, the study duration was relatively short.

“Larger, multicenter studies are needed to further understand prognostic factors and survival outcomes among Asian patients with MF,” the authors wrote.