Prognostic value of blood eosinophilia in primary cutaneous T-cell lymphomas.
OBJECTIVE
To investigate the prognostic value of initial characteristics including blood eosinophilia in patients with primary cutaneous T-cell lymphoma.


METHODS
A retrospective inception cohort, patients included from date of diagnosis (1982-1998).


METHODS
Two dermatology departments of a university hospital. Patients A total of 104 patients with cutaneous T-cell lymphoma, including patients with mycosis fungoides (n = 69), Sézary syndrome (n = 13), and nonepidermotropic cutaneous lymphoma (n = 22). The following variables were recorded: age, sex, diagnosis according to the European Organization for Research and Treatment of Cancer (EORTC) classification, type of skin involvement at the time of diagnosis, initial eosinophil absolute count, lactate dehydrogenase value, date of disease progression, and cause and date of death or date of last contact.


METHODS
Time from diagnosis to disease progression and to disease-specific death.


RESULTS
The median follow-up was 43 months (range, 7-197 months). Estimated rates of disease progression and disease-specific death for 3 years were 19.5% (95% confidence interval [CI],11.3%-27.6%) and 9.9% (95% CI, 2.8%-13.6%), respectively. Univariable analysis of initial variables possibly influencing disease progression revealed significant prognostic value for diagnosis according to EORTC classification (hazard ratio [HR], 2.77; 95% CI, 1.04-7.41; P =.04), type of skin involvement (HR, 2.70; 95% CI, 1.00-7.25; P =.04), raised blood eosinophil absolute count (HR, 7.33; 95% CI, 2.84-18.91; P<.001), and raised serum level of lactate dehydrogenase (HR, 3.72; 95% CI, 1.58-8.78; P =.001). Concerning disease-specific death, significant prognostic indicators were diagnosis according to the EORTC classification (HR, 6.62; 95% CI, 1.68-26.12; P =.007) and a raised blood eosinophil absolute count (HR, 10.57; 95% CI, 2.28-49.0; P<.001). In multivariable analysis, only blood eosinophilia was associated with disease progression and disease-specific death.


CONCLUSIONS
These results strongly suggest that blood eosinophilia at baseline is a prognostic factor in patients with primary cutaneous T-cell lymphoma.
Tancrède-Bohin
Emmanuelle
E
Department of Dermatology 2, Hôpital Saint-Louis, Paris, France. emmanuelle.tancrede-bohin@wanadoo.fr
Ionescu
Marius Anton
MA
de La Salmonière
Pauline
P
Dupuy
Alain
A
Rivet
Jacqueline
J
Rybojad
Michel
M
Dubertret
Louis
L
Bachelez
Hervé
H
Lebbé
Celeste
C
Morel
Patrice
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D004802:Eosinophilia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016410:Lymphoma, T-Cell, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers