Care structure of patients with mycosis fungoides and Sézary syndrome in Germany - Care research based on SHI claims data.

Abstract

Cutaneous T-cell lymphomas (CTCLs) are rare forms of non-Hodgkin's lymphoma of T-cell origin that occur mainly in the skin. The most common form is mycosis fungoides (MF), but Sézary syndrome (SS), a more aggressive form of CTCL, is another relevant subgroup. Due to the rare nature of the disease, population-based studies of the epidemiology and disease burden and insights into care delivery are limited. Based on an anonymized, age and sex-adjusted routine dataset comprising approximately five million people with statutory health insurance, a retrospective, longitudinal healthcare research study was conducted over a six-year period (2012-2017). In 55% of patients with MF and SS, the initial diagnosis was documented in an outpatient setting; in 59% of cases by a dermatologist. Immunophenotyping by flow cytometry is considered an important investigative tool for the detection and follow-up surveillance of blood involvement of cutaneous lymphomas, as the disease stage is the most important prognostic factor in MF and SS; this was performed in only 10% of patients. The first-line treatment was topical (76%), in particular with corticosteroids (66%). The findings from this healthcare research point to the need for increased guideline-based care.