Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study

Frederick Lansigan; Steven M. Horwitz; Lauren C. Pinter-Brown; Kenneth R. Carson; Andrei R. Shustov; Steven T. Rosen; Barbara Pro; Eric D. Hsi; Massimo Federico; Christian Gisselbrecht; Marc Schwartz; Lisa A. Bellm; Mark Acosta; Francine M. Foss

doi:10.1016/j.clml.2020.05.001

Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study

Frederick Lansigan, Steven M. Horwitz, Lauren C. Pinter-Brown, Kenneth R. Carson, Andrei R. Shustov, Steven T. Rosen, Barbara Pro, Eric D. Hsi, Massimo Federico, Christian Gisselbrecht, Marc Schwartz, Lisa A. Bellm, Mark Acosta, Francine M. Foss^*

^*Corresponding author for this work

Medicine, Hematology Oncology Division

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Introduction: We examined patient characteristics, treatments, and outcomes of patients with transformed mycosis fungoides (tMF) from COMPLETE: a large, multicenter, prospective cohort study of peripheral T-cell lymphoma patients in the United States. Methods: Patients with tMF were enrolled in COMPLETE at the time of transformation. For this analysis, we identified patients with tMF with completed baseline, treatment, and follow-up records. Median survival was assessed using Kaplan-Meier methodology. Results: Of the 499 patients enrolled in COMPLETE, 17 had tMF. Median age was 61; 53% were male, 9 had elevated lactate dehydrogenase, and 9 had lymph node involvement. Approximately one-quarter of the patients were African American and 47% had CD30+ disease. Median time to transformation was 53 months. All patients received systemic therapy, with 19% receiving concomitant radiotherapy. Most patients (87%) received single agents, including liposomal doxorubicin, pralatrexate, and gemcitabine. Eight patients (50%) had reported responses to therapy. Median survival was 18 months. One- and 2-year survival rates were 56% and 44%, respectively. Conclusions: tMF often expresses CD30 and presents with lymph node involvement. Responses have been seen with single agents, but survival remains poor. Novel treatment approaches are urgently needed to improve outcomes.

Original language	English (US)
Pages (from-to)	744-748
Number of pages	5
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	20
Issue number	11
DOIs	https://doi.org/10.1016/j.clml.2020.05.001
State	Published - Nov 2020

Funding

F. Lansigan has reported a consulting or advisory role for Spectrum Pharmaceuticals and Celgene, and research funding from Spectrum Pharmaceuticals. S.M. Horwitz has reported a consulting or advisory role for Celgene, Millenium/Takeda, Kyowa-Hakka-Kirin, Seattle Genetics, Forty-Seven, Mundipharma, and Verastem; and research funding from Celgene, Millenium/Takeda, Kyowa-Hakka-Kirin, Seattle Genetics, Forty-Seven, Infinity/Verastem, Spectrum Pharmaceuticals, ADCT Therapeutics, and Aileron Therapeutics. K.R. Carson is an employee of Flatiron Health; has stock or other ownership in Flatiron Health; received research funding from Kyowa Hakko Kirin and Celgene; and received travel, accommodations, expenses from Flatiron Health. A. Shustov has received honoraria from Verastem; research funding from Spectrum Pharmaceuticals; and travel, accommodations, expenses from Spectrum Pharmaceuticals. S.T. Rosen has received honoraria from Celgene, Pharmacyclics, Valeant Pharmaceuticals International; has had a consulting or advisory role with Celgene, Genentech, Seattle Genetics, and Aileron Therapeutics; was a member of the speakers' bureau of The Scienomics Group, Xcenda, and AmerisourceBergen; and has received research funding from Celgene. B. Pro has received research grants and personal fees outside the submitted work from Seattle Genetics, Takeda, Kiowa, and Portola. E.D. Hsi has had a consulting or advisory role with Seattle Genetics and Celgene; and has received research funding from Eli Lilly and AbbVie. M. Federico has had a consulting or advisory role with MedNet Solutions. M. Schwartz has had other relationship with MS Biostatistics, LLC. L. Bellm reports relationship with MedNet Solutions. M. Acosta reports employment, stock or other ownership, and travel, accommodations, and expenses with Spectrum Pharmaceuticals. F.M. Foss reports a consulting or advisory role with Celgene, Seattle Genetics, Spectrum Pharmaceuticals, Eisai, Millennium, and Verastem; speakers' bureau with Seattle Genetics and Celgene; and research funding from Celgene. All other authors state that they have no conflicts of interest.This work was supported by Spectrum Pharmaceuticals, Inc. F. Lansigan has reported a consulting or advisory role for Spectrum Pharmaceuticals and Celgene, and research funding from Spectrum Pharmaceuticals . S.M. Horwitz has reported a consulting or advisory role for Celgene, Millenium/Takeda, Kyowa-Hakka-Kirin, Seattle Genetics, Forty-Seven, Mundipharma, and Verastem; and research funding from Celgene , Millenium /Takeda, Kyowa-Hakka-Kirin , Seattle Genetic s, Forty-Seven , Infinity /Verastem, Spectrum Pharmaceuticals , ADCT Therapeutics, and Aileron Therapeutics. K.R. Carson is an employee of Flatiron Health; has stock or other ownership in Flatiron Health; received research funding from Kyowa Hakko Kirin and Celgene ; and received travel, accommodations, expenses from Flatiron Health. A. Shustov has received honoraria from Verastem; research funding from Spectrum Pharmaceuticals ; and travel, accommodations, expenses from Spectrum Pharmaceuticals. S.T. Rosen has received honoraria from Celgene, Pharmacyclics, Valeant Pharmaceuticals International; has had a consulting or advisory role with Celgene, Genentech, Seattle Genetics, and Aileron Therapeutics; was a member of the speakers' bureau of The Scienomics Group, Xcenda, and AmerisourceBergen; and has received research funding from Celgene . B. Pro has received research grants and personal fees outside the submitted work from Seattle Genetics , Takeda , Kiowa , and Portola . E.D. Hsi has had a consulting or advisory role with Seattle Genetics and Celgene; and has received research funding from Eli Lilly and AbbVie . M. Federico has had a consulting or advisory role with MedNet Solutions. M. Schwartz has had other relationship with MS Biostatistics, LLC. L. Bellm reports relationship with MedNet Solutions. M. Acosta reports employment, stock or other ownership, and travel, accommodations, and expenses with Spectrum Pharmaceuticals. F.M. Foss reports a consulting or advisory role with Celgene, Seattle Genetics, Spectrum Pharmaceuticals, Eisai, Millennium, and Verastem; speakers' bureau with Seattle Genetics and Celgene; and research funding from Celgene . All other authors state that they have no conflicts of interest.

Keywords

COMPLETE registry
Cutaneous T-cell lymphomas
Large-cell transformation
Overall survival,
Progression-free survival

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.clml.2020.05.001

Cite this

Lansigan, F., Horwitz, S. M., Pinter-Brown, L. C., Carson, K. R., Shustov, A. R., Rosen, S. T., Pro, B., Hsi, E. D., Federico, M., Gisselbrecht, C., Schwartz, M., Bellm, L. A., Acosta, M., & Foss, F. M. (2020). Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study. Clinical Lymphoma, Myeloma and Leukemia, 20(11), 744-748. https://doi.org/10.1016/j.clml.2020.05.001

@article{c049d4afa01b4dc98e6c51428da17c32,

title = "Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study",

abstract = "Introduction: We examined patient characteristics, treatments, and outcomes of patients with transformed mycosis fungoides (tMF) from COMPLETE: a large, multicenter, prospective cohort study of peripheral T-cell lymphoma patients in the United States. Methods: Patients with tMF were enrolled in COMPLETE at the time of transformation. For this analysis, we identified patients with tMF with completed baseline, treatment, and follow-up records. Median survival was assessed using Kaplan-Meier methodology. Results: Of the 499 patients enrolled in COMPLETE, 17 had tMF. Median age was 61; 53% were male, 9 had elevated lactate dehydrogenase, and 9 had lymph node involvement. Approximately one-quarter of the patients were African American and 47% had CD30+ disease. Median time to transformation was 53 months. All patients received systemic therapy, with 19% receiving concomitant radiotherapy. Most patients (87%) received single agents, including liposomal doxorubicin, pralatrexate, and gemcitabine. Eight patients (50%) had reported responses to therapy. Median survival was 18 months. One- and 2-year survival rates were 56% and 44%, respectively. Conclusions: tMF often expresses CD30 and presents with lymph node involvement. Responses have been seen with single agents, but survival remains poor. Novel treatment approaches are urgently needed to improve outcomes.",

keywords = "COMPLETE registry, Cutaneous T-cell lymphomas, Large-cell transformation, Overall survival,, Progression-free survival",

author = "Frederick Lansigan and Horwitz, {Steven M.} and Pinter-Brown, {Lauren C.} and Carson, {Kenneth R.} and Shustov, {Andrei R.} and Rosen, {Steven T.} and Barbara Pro and Hsi, {Eric D.} and Massimo Federico and Christian Gisselbrecht and Marc Schwartz and Bellm, {Lisa A.} and Mark Acosta and Foss, {Francine M.}",

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year = "2020",

month = nov,

doi = "10.1016/j.clml.2020.05.001",

language = "English (US)",

volume = "20",

pages = "744--748",

journal = "Clinical Lymphoma, Myeloma and Leukemia",

issn = "2152-2650",

publisher = "Cancer Media Group",

number = "11",

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Lansigan, F, Horwitz, SM, Pinter-Brown, LC, Carson, KR, Shustov, AR, Rosen, ST, Pro, B, Hsi, ED, Federico, M, Gisselbrecht, C, Schwartz, M, Bellm, LA, Acosta, M & Foss, FM 2020, 'Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study', Clinical Lymphoma, Myeloma and Leukemia, vol. 20, no. 11, pp. 744-748. https://doi.org/10.1016/j.clml.2020.05.001

TY - JOUR

T1 - Outcomes of Patients with Transformed Mycosis Fungoides

T2 - Analysis from a Prospective Multicenter US Cohort Study

AU - Lansigan, Frederick

AU - Horwitz, Steven M.

AU - Pinter-Brown, Lauren C.

AU - Carson, Kenneth R.

AU - Shustov, Andrei R.

AU - Rosen, Steven T.

AU - Pro, Barbara

AU - Hsi, Eric D.

AU - Federico, Massimo

AU - Gisselbrecht, Christian

AU - Schwartz, Marc

AU - Bellm, Lisa A.

AU - Acosta, Mark

AU - Foss, Francine M.

PY - 2020/11

Y1 - 2020/11

N2 - Introduction: We examined patient characteristics, treatments, and outcomes of patients with transformed mycosis fungoides (tMF) from COMPLETE: a large, multicenter, prospective cohort study of peripheral T-cell lymphoma patients in the United States. Methods: Patients with tMF were enrolled in COMPLETE at the time of transformation. For this analysis, we identified patients with tMF with completed baseline, treatment, and follow-up records. Median survival was assessed using Kaplan-Meier methodology. Results: Of the 499 patients enrolled in COMPLETE, 17 had tMF. Median age was 61; 53% were male, 9 had elevated lactate dehydrogenase, and 9 had lymph node involvement. Approximately one-quarter of the patients were African American and 47% had CD30+ disease. Median time to transformation was 53 months. All patients received systemic therapy, with 19% receiving concomitant radiotherapy. Most patients (87%) received single agents, including liposomal doxorubicin, pralatrexate, and gemcitabine. Eight patients (50%) had reported responses to therapy. Median survival was 18 months. One- and 2-year survival rates were 56% and 44%, respectively. Conclusions: tMF often expresses CD30 and presents with lymph node involvement. Responses have been seen with single agents, but survival remains poor. Novel treatment approaches are urgently needed to improve outcomes.

AB - Introduction: We examined patient characteristics, treatments, and outcomes of patients with transformed mycosis fungoides (tMF) from COMPLETE: a large, multicenter, prospective cohort study of peripheral T-cell lymphoma patients in the United States. Methods: Patients with tMF were enrolled in COMPLETE at the time of transformation. For this analysis, we identified patients with tMF with completed baseline, treatment, and follow-up records. Median survival was assessed using Kaplan-Meier methodology. Results: Of the 499 patients enrolled in COMPLETE, 17 had tMF. Median age was 61; 53% were male, 9 had elevated lactate dehydrogenase, and 9 had lymph node involvement. Approximately one-quarter of the patients were African American and 47% had CD30+ disease. Median time to transformation was 53 months. All patients received systemic therapy, with 19% receiving concomitant radiotherapy. Most patients (87%) received single agents, including liposomal doxorubicin, pralatrexate, and gemcitabine. Eight patients (50%) had reported responses to therapy. Median survival was 18 months. One- and 2-year survival rates were 56% and 44%, respectively. Conclusions: tMF often expresses CD30 and presents with lymph node involvement. Responses have been seen with single agents, but survival remains poor. Novel treatment approaches are urgently needed to improve outcomes.

KW - COMPLETE registry

KW - Cutaneous T-cell lymphomas

KW - Large-cell transformation

KW - Overall survival,

KW - Progression-free survival

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DO - 10.1016/j.clml.2020.05.001

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SN - 2152-2650

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JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

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Outcomes of Patients with Transformed Mycosis Fungoides: Analysis from a Prospective Multicenter US Cohort Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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