CD8+ mycosis fungoides: A low-grade lymphoproliferative disorder

Maria Estela Martinez-Escala, Robert W. Kantor, Ahuva Cices, Alan Zhou, Jason B. Kaplan, Barbara Pro, Jaehyuk Choi, Joan Guitart*

*Corresponding author for this work

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8+ MF compared with CD4+ MF. Objectives To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution. Methods This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4+ from the relevant literature. Results Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8+ MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004). Limitations This is a retrospective review. Conclusion Our experience with CD8+ MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.

Original languageEnglish (US)
Pages (from-to)489-496
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume77
Issue number3
DOIs
StatePublished - Sep 1 2017

Fingerprint

Mycosis Fungoides
Lymphoproliferative Disorders
Surface Antigens
Observation
Pediatrics
Skin

Keywords

  • CD8 phenotype
  • cutaneous lymphoma
  • lymphoproliferative disorder
  • mycosis fungoides
  • prognosis
  • skin directed-therapies

ASJC Scopus subject areas

  • Dermatology

Cite this

Martinez-Escala, Maria Estela ; Kantor, Robert W. ; Cices, Ahuva ; Zhou, Alan ; Kaplan, Jason B. ; Pro, Barbara ; Choi, Jaehyuk ; Guitart, Joan. / CD8+ mycosis fungoides : A low-grade lymphoproliferative disorder. In: Journal of the American Academy of Dermatology. 2017 ; Vol. 77, No. 3. pp. 489-496.
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abstract = "Background The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8+ MF compared with CD4+ MF. Objectives To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution. Methods This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4+ from the relevant literature. Results Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8+ MF patients at diagnosis when compared with other cohorts, including 31 (47{\%}) patients with stage IA, 33 (50{\%}) with stage IB, and 2 (3{\%}) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5{\%}, P = .001), and a lower rate of progression was observed (P = .004). Limitations This is a retrospective review. Conclusion Our experience with CD8+ MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.",
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CD8+ mycosis fungoides : A low-grade lymphoproliferative disorder. / Martinez-Escala, Maria Estela; Kantor, Robert W.; Cices, Ahuva; Zhou, Alan; Kaplan, Jason B.; Pro, Barbara; Choi, Jaehyuk; Guitart, Joan.

In: Journal of the American Academy of Dermatology, Vol. 77, No. 3, 01.09.2017, p. 489-496.

Research output: Contribution to journalArticle

TY - JOUR

T1 - CD8+ mycosis fungoides

T2 - A low-grade lymphoproliferative disorder

AU - Martinez-Escala, Maria Estela

AU - Kantor, Robert W.

AU - Cices, Ahuva

AU - Zhou, Alan

AU - Kaplan, Jason B.

AU - Pro, Barbara

AU - Choi, Jaehyuk

AU - Guitart, Joan

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8+ MF compared with CD4+ MF. Objectives To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution. Methods This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4+ from the relevant literature. Results Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8+ MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004). Limitations This is a retrospective review. Conclusion Our experience with CD8+ MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.

AB - Background The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8+ MF compared with CD4+ MF. Objectives To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution. Methods This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4+ from the relevant literature. Results Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8+ MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004). Limitations This is a retrospective review. Conclusion Our experience with CD8+ MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.

KW - CD8 phenotype

KW - cutaneous lymphoma

KW - lymphoproliferative disorder

KW - mycosis fungoides

KW - prognosis

KW - skin directed-therapies

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