Age, Race, Sex, Stage, and Incidence of Cutaneous Lymphoma
ABSTRACT The incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.
The SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.
Of 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).
Nonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.
- SourceAvailable from: Hendrik Borgmann
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- "Mycosis fungoides accounts for 0.5% of all malignant lymphomas and for 44% of all cutaneous lymphomas,1 and has an incidence of 0.5/100.000/year.2 It occurs predominantly in men of middle and higher age.3 Mycosis fungoides develops slowly from a premycoside stadium with an uncharacteristic skin pattern over the plaque stadium with extensive infiltrating foci to a tumor stadium with fungus formed ulcerating foci. "
ABSTRACT: Testicular neoplasms occur in more than 90% of cases, due to primary testicular germ cell tumors. Other entities are non germ cell tumors of the testis, testicular manifestation of lymphomas or metastases. International and interdisciplinary co-operation has led to the development of urological guidelines and to good therapeutic success for testicular neoplasms. The gold standard for treatment of a testicular neoplasm is the radical orchiectomy. However, for individual cases with suspected lymphoma, a treatment decision differing from the guidelines may be reasonable. We present the case of a 38-year-old man with testicular manifestation of a transformed mycosis fungoides, which is the most common form of cutaneous T-cell lymphoma.Rare tumors 01/2014; 6(1):5079. DOI:10.4081/rt.2014.5079
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ABSTRACT: BACKGROUND: Primary cutaneous lymphoma (PCL) comprises a heterogeneous group of diseases in regard to clinical presentation, histologic appearance, and biological behavior. Its rare occurrence limits analysis of disease features and survival of patients. PATIENTS AND METHODS: All patients with PCL treated in our hospital during January 2006 to October 2012 were included in this retrospective study. Their histologic and clinical data were analyzed. The diagnosis of PCL and the evaluation of clinical behavior were based on the 2005 World Health Organization-European Organisation for Research and Treatment of Cancer (WHO-EORTC) classification. RESULTS: Fifty-four cases of PCL were included in the study. The median age was 52.5 years. Thirteen (24.1%) patients had B-cell lymphoma and 41 (75.9%) had T-cell lymphoma. Twenty-nine (53.7%) patients exhibited disease having indolent clinical behavior, 14 (25.9%) presented with B symptoms, and 16 (29.6%) had elevated lactate dehydrogenase (LDH) levels at baseline. Within a median follow-up of 47.8 months, the expected 5-year progression-free survival (PFS) rate and overall survival (OS) rate were 6% and 14%, respectively. Using multivariate analysis, aggressive behavior (hazard ratio [HR], 2.92; P = .01] and elevated LDH levels at baseline (HR, 2.88; P = .01) were identified as independent risk factors for PFS. In addition, aggressive behavior (HR, 4.09; P = .01) and elevated LDH levels at baseline (HR, 3.69; P = .01) were also identified as independent risk factors for OS. CONCLUSION: The study data suggest that aggressive behavior and elevated LDH levels at baseline were predictive factors for poor PFS and OS, which supports the need for immediate treatment of those patients.Clinical lymphoma, myeloma & leukemia 06/2013; 13(5). DOI:10.1016/j.clml.2013.04.011 · 2.02 Impact Factor
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ABSTRACT: 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 to 30 of 45 (66%) of Caucasian patients were treated with ECP (p= .029). Additionally, ECP was discussed as an option for 45% of African-Americans compared to 82% of Caucasians (p=.007). When discussed as an option, African-Americans and Caucasians had identical rates of ECP use (78% vs 81%, p=.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 which influence treatment decision making may help diminish discrepancies in treatment regimens among patients with MF.Journal of Dermatological Treatment 07/2014; DOI:10.3109/09546634.2014.946381 · 1.76 Impact Factor