CD8+ mycosis fungoides: A low-grade lymphoproliferative disorder

Abstract

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. To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution. 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. Sixty-seven patients of a median age of 46years 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 (5.5years, range 0.2-21years) 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). This is a retrospective review. 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.