title: Racial differences in the use of extracorporeal photopheresis for mycosis fungoides.
abstract: BACKGROUND
  Extracorporeal photopheresis (ECP) is an effective treatment option for mycosis fungoides (MF) and associated with few systemic side effects.
  
  
  OBJECTIVE
  We sought to investigate whether there were differences in rates of ECP use between African-American and Caucasian patients with stage III/IV MF.
  
  
  METHODS
  We conducted a retrospective review of all patients treated for MF at the Johns Hopkins Hospital main campus outpatient clinic between 1999 and 2011.
  
  
  RESULTS
  We identified 65 patients with stage III or IV disease, 20 African-American and 45 Caucasian. Only 7 of 20 African-American patients (35%) compared with 30 of 45 (66%) of Caucasian patients were treated with ECP (p = 0.029). In addition, ECP was discussed as an option for 45% of African-Americans compared to 82% of Caucasians (p = 0.007). When discussed as an option, African-Americans and Caucasians had identical rates of ECP use (78% vs 81%, p = 0.841).
  
  
  CONCLUSIONS
  Differences in rates of ECP use exist among African-American patients when compared to their Caucasian counterparts and may be related to how often ECP is offered as a treatment option. Improving physician awareness of the factors that influence treatment decision making may help diminish discrepancies in treatment regimens among patients with MF.
authors.affiliation: Department of Dermatology, Johns Hopkins School of Medicine , Baltimore, MD , USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Agi
authors.forename: Diane
authors.initials: D
authors.lastname: Kuhn
authors.forename: Jina
authors.initials: J
authors.lastname: Chung
authors.forename: John
authors.initials: J
authors.lastname: Zampella
authors.forename: Ginette
authors.initials: G
authors.lastname: Hinds
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000628:therapy*; D017893:Photopheresis / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cutaneous T-cell lymphoma; ECP; ethnic skin; mycosis fungoides