SEARCH:   Advanced

Blood, 15 October 2008, Vol. 112, No. 8, pp. 3082-3087. Prepublished online as a Blood First Edition Paper on July 22, 2008; DOI 10.1182/blood-2008-05-154609. This Article Full Text (PDF) All Versions of this Article: blood-2008-05-154609v1 112/8/3082    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Arulogun, S. O Articles by McCormack, C. Search for Related Content PubMed PubMed Citation Articles by Arulogun, S. O Articles by McCormack, C. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 1, 2008 Accepted June 29, 2008 Long term outcomes of patients with advanced-stage cutaneous T cell lymphoma and large cell transformation Suzanne O Arulogun, H. Miles Prince*, Jonathan Ng, Stephen Lade, Gail F. Ryan, Odette Blewitt, and Christopher McCormack Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia Monash University, Clayton, Melbourne, Australia Department of Dermatology, St Vincent's Hospital, Melbourne, Australia Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia University of Melbourne, Parkville, Melbourne, Australia * Corresponding author; email: miles.prince{at}petermac.org. Although mycosis fungoides is typically an indolent disease, patients with advanced-stage disease (stages IIB-IVB), including Sezary syndrome, often have a poor outcome. A 31-year, retrospective analysis of our cutaneous lymphoma database, of 297 patients with mycosis fungoides (MF) and Sezary syndrome (SS), was undertaken to study long-term outcomes and identify clinical predictors of outcome in patients with advanced-stage disease (ASD; n=92) and large cell transformation (LCT; n=22). Two-thirds of patients with ASD presented with de novo ASD. The median overall survival (OS) for ASD was five years with a 10-year predicted OS of 32%. Age at initial diagnosis (P=0.01), tumor stage (P=0.01) and clinical stage (P=0.0003) were found to be significant predictors of outcome. Patients who presented with de novo ASD demonstrated better outcomes that were not statistically significant than those with a prior diagnosis of early-stage MF (P=0.25). Large cell transformation is pathologically characterised by the morphologic change of small-/medium-sized cells to large cells that comprise >25% of a MF lesion. Transformation developed in 22 of the 297 MF/SS patients (7.4%), with a transformation rate of only 1.4% in patients with early-stage disease, compared with stage IIB (27%) and stage IV (56%-67%) disease. The median OS from diagnosis of LCT was two years. We confirm that the incidence of LCT is strongly dependent on tumor stage at diagnosis and demonstrate a much lower overall risk of LCT than previously reported. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: H. M. Prince, S. Whittaker, and R. T. Hoppe How I treat mycosis fungoides and Sezary syndrome Blood, November 12, 2009; 114(20): 4337 - 4353. [Abstract] [Full Text] [PDF] P. Chandra, J. A. Plaza, Z. Zuo, A. H. Diwan, H. Koeppen, M. Duvic, L. J. Medeiros, and V. G. Prieto Clusterin Expression Correlates With Stage and Presence of Large Cells in Mycosis Fungoides Am J Clin Pathol, April 1, 2009; 131(4): 511 - 515. [Abstract] [Full Text] [PDF]

	Copyright © 2008 by American Society of Hematology         Online ISSN: 1528-0020