Mycosis fungoides. Hematologic findings and terminal course.

Abstract

This paper summarizes our clinical experience with 165 cases of biopsy-proved mycosis fungoides. In 34% of the 106 deceased patients there was a transition from mycosis fungoides to reticulum cell sarcoma (14 cases), to lymphosarcoma (15 cases), or to Hodgkin's disease (7 cases). Five of the 14 patients with reticulum cell sarcoma had terminal monocytic leukemia, and six of the 15 with lymphosarcoma had terminal lymphoblastic leukemia. In 23 of the 42 patients autopsied the disease remained as mycosis fungoides throughout its course. The pleomorphic infiltrate without Sternberg-Reed cells involved the lymph nodes in four and the viscera in nine of the patients autopsied. No findings in the blood or marrow could be considered as pathognomonic of mycosis fungoides except perhaps an absolute lymphopenia noted in 76% of the patients. Total body surface electron beam therapy is the most effective and practical form of palliative therapy. Skin tolerance is the only limiting factor; bone marrow is not significantly affected.