title: Clinical characteristics, prognostic factors, and survival of 393 patients with mycosis fungoides and Sézary syndrome in the southeastern United States: a single-institution cohort.
abstract: BACKGROUND
  Limited data exist on patients with mycosis fungoides (MF) and Sézary syndrome (SS) from the southeastern United States, a region with a high proportion of African Americans (AA).
  
  
  OBJECTIVE
  We sought to determine clinical characteristics, prognostic factors, and survival of patients with MF/SS in a southeastern US cohort, compare with other cohorts, and validate proposed revisions in MF/SS staging.
  
  
  METHODS
  This was a retrospective chart review of patients from an academic dermatology referral center (Atlanta, GA) from 1998 to 2013. Kaplan-Meier estimates were calculated for overall survival, disease-specific survival, and progression; univariate and multivariate Cox proportional hazard models were used for assessment of prognostic variables.
  
  
  RESULTS
  Of 393 patients, 55.2% were white, 43.3% AA, and 1.5% other; 52.7% were male and 47.3% female (ratio 1.1:1). Mean age was 53.6 years; mean age among AA was 48.9 years. In all, 19.6% died of disease; 21.9% experienced disease progression. Advanced TNMB classification, presence of a circulating clone without phenotypic evidence of blood involvement, and older age were predictors of poor disease-specific survival in the multivariate analysis, whereas AA race was not.
  
  
  CONCLUSIONS
  This study was from a single academic center.
  
  
  CONCLUSIONS
  Outcomes of our patients generally paralleled those of other geographic regions. MF/SS may affect younger patients and more women than previously recognized, particularly among AA. Survival among AA may be more favorable than that observed in prior reports. Our data support the validity of the staging criteria revisions for MF/SS.
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Megan
authors.initials: M
authors.lastname: Desai
authors.affiliation: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Shuling
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Grady Health System, Atlanta, Georgia. Electronic address: srsingh@emory.edu.
authors.forename: Sareeta
authors.initials: S
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009182:Mycosis Fungoides / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D009367:Neoplasm Staging / Q000592:standards*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D017678:Sex Distribution; D012751:Sezary Syndrome / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D015144:Southeastern United States / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: African American; cutaneous T-cell lymphoma; mycosis fungoides; prognosis; survival