Prognostic factor analysis in mycosis fungoides/Sézary syndrome.
BACKGROUND
The influence of prognostic factors on survival in patients with mycosis fungoides/Sézary syndrome (MF/SS) is less well described than for other lymphomas.


OBJECTIVE
Our purpose was to evaluate the prognostic value of diverse clinicopathologic and laboratory characteristics in patients with MF/SS.


METHODS
All 115 patients with MF/SS seen at the Mycosis Fungoides clinic at M. D. Anderson Cancer Center during the study period who had slides available for pathologic review were analyzed. Univariate and multivariate methodologies were used.


RESULTS
Age (> or = 60 years; P = .0002), advanced stage (P < 10(-5)), tumor (T3) stage disease (P < or = 10(-5)), lymphadenopathy (P = .006), bone marrow infiltration (P = .03), high lactate dehydrogenase (LDH; P = .0002), high beta2-microglobulin (> 2 mg/L; P = .009), and transformation to large-cell lymphoma (P = .004) were significant prognostic factors in the univariate analysis and correlated with a poorer survival. The outcome of patients staged as IIB was significantly worse than that of those staged as I or IIA or III (P < .001) and was comparable to that of the patients staged as IV (P = .8). In the multivariate analysis, the factors selected include stage (I to IIA and III vs IIB and IV; P < .0001), LDH (P = .006), and age (> or = 60 vs < 60 years; P = .02). The actuarial median survival of patients with advanced stage, high LDH, or age 60 years or more was 2.5 to 3.5 years, whereas that of patients without any of these parameters was more than 13 years.


CONCLUSIONS
Our results suggest that patients with MF/SS who are staged as IIB or IV, who have a high LDH, or who are 60 years of age or older have an aggressive course and poor survival.
Diamandidou
E
E
Department of Bioimmunotherapy, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA.
Colome
M
M
Fayad
L
L
Duvic
M
M
Kurzrock
R
R
D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009182:Mycosis Fungoides / Q000097:blood / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012751:Sezary Syndrome / Q000401:mortality* / Q000473:pathology; D012878:Skin Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin; D007770:L-Lactate Dehydrogenase