282 Lifestyle and demographic risk factors in mycosis fungoides and Sezary syndrome: A single institution cohort study

Abstract

Background: Mycosis fungoides (MF) and Sezary syndrome (SS) are common subtypes of cutaneous T-cell lymphoma (CTCL). Risk factors and impact on quality of life (QoL) are poorly understood. Previous studies of CTCL risk factors have not analyzed disease stage, severity, and QoL together. We explored associations between demographic and lifestyle factors and these parameters. Methods: A cohort study was conducted at a large CTCL multidisciplinary clinic from April 2019 to December 2020. REDCap surveys were administered to 115 MF/SS patients, investigating 11 demographic and lifestyle factors. QoL was evaluated using Skindex-29; pain and itch with Likert scales. Disease severity was assessed using the modified Severity Weighted Assessment Tool (mSWAT). Factors were compared using t-test, chi-squared, and linear or logistic regression models. Results: History of chemical exposures was associated with greater disease severity (p=0.034) and worse QoL (p=0.005), but not with pain/itch severity (p=0.118). Disease severity and stage were associated with worse QoL (both p<0.001). There were significant racial differences in early (IA-IIB) versus late (IIIA-IV) stage disease (p=0.034) and QoL (p=0.039). There was a significant relationship between smoking and disease stage (p=0.028) but not severity (p=0.360). Obesity was correlated with disease severity (p=0.021), but not with stage or QoL (p=0.582; 0.232). Conclusion: We provide an analysis of patient lifestyle and demographic factors in the context of MF/SS severity, stage, and QoL. We identified race and smoking as potential risk factors for advanced disease, and chemical exposures and obesity for increased disease severity. Worse QoL was significantly associated with a history of chemical exposure, severe pain/itch, race, and stage. Identification of demographic and lifestyle associations in MF/SS will enable physicians to provide more individualized patient care and education.