Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sezary Syndrome: Effect of Specific Prognostic Markers on Survival and Development of a Prognostic Model

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art_SCARISBRICK_Cutaneous_Lymphoma_International_Consortium_Study_of_Outcome_in_2015.PDF (200.85 KB)
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319
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article
Data de publicação
2015
Editora
AMER SOC CLINICAL ONCOLOGY
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Scopus
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PubMed
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Autores
SCARISBRICK, Julia J.
PRINCE, H. Miles
VERMEER, Maarten H.
QUAGLINO, Pietro
HORWITZ, Steven
PORCU, Pierluigi
STADLER, Rudolf
WOOD, Gary S.
BEYLOT-BARRY, Marie
PHAM-LEDARD, Anne
Autor de Grupo de pesquisa
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Citação
JOURNAL OF CLINICAL ONCOLOGY, v.33, n.32, p.3766-0, 2015
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Resumo
Purpose Advanced-stage mycosis fungoides (MF; stage IIB to IV) and Sezary syndrome (SS) are aggressive lymphomas with a median survival of 1 to 5 years. Clinical management is stage based; however, there is wide range of outcome within stages. Published prognostic studies in MF/SS have been single-center trials. Because of the rarity of MF/SS, only a large collaboration would power a study to identify independent prognostic markers. Patients and Methods Literature review identified the following 10 candidate markers: stage, age, sex, cutaneous histologic features of folliculotropism, CD30 positivity, proliferation index, large-cell transformation, WBC/lymphocyte count, serum lactate dehydrogenase, and identical T-cell clone in blood and skin. Data were collected at specialist centers on patients diagnosed with advanced-stage MF/SS from 2007. Each parameter recorded at diagnosis was tested against overall survival (OS). Results Staging data on 1,275 patients with advanced MF/SS from 29 international sites were included for survival analysis. The median OS was 63 months, with 2- and 5-year survival rates of 77% and 52%, respectively. The median OS for patients with stage IIB disease was 68 months, but patients diagnosed with stage III disease had slightly improved survival compared with patients with stage IIB, although patients diagnosed with stage IV disease had significantly worse survival (48 months for stage IVA and 33 months for stage IVB). Of the 10 variables tested, four (stage IV, age > 60 years, large-cell transformation, and increased lactate dehydrogenase) were independent prognostic markers for a worse survival. Combining these four factors in a prognostic index model identified the following three risk groups across stages with significantly different 5-year survival rates: low risk (68%), intermediate risk (44%), and high risk (28%). Conclusion To our knowledge, this study includes the largest cohort of patients with advanced-stage MF/SS and identifies markers with independent prognostic value, which, used together in a prognostic index, may be useful to stratify advanced-stage patients. (C) 2015 by American Society of Clinical Oncology
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https://observatorio.fm.usp.br/handle/OPI/12682
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/53
Artigos e Materiais de Revistas Científicas - ODS/03