Mycosis fungoides in a referral center in central Taiwan: A retrospective case series and literature review

Abstract

Mycosis fungoides (MF) comprises the majority of cutaneous T-cell lymphomas (CTCLs). CTCLs associated with eosinophilia have a poor prognosis. Similar results were shown in white and black individuals with MF; however, the data on Asians is scant. In the past 10 years, few studies have provided profiles of the characteristics of MF patients in Taiwan. The purpose of this study was to investigate the demographic, clinicopathologic features, and prognosis of MF patients in Taiwan. A retrospective analysis was used to evaluate patients with MF in a referral center in central Taiwan covering a period of 16 years, from 1997 to 2013. The records of 22 Taiwanese patients with MF were reviewed for clinical, laboratory, and histopathologic data and evaluated by analysis of variance. The male to female ratio was approximately 2:1. The average age at diagnosis was 44.8 years. One pediatric patient presented with hypopigmented MF, and the other 21 patients had typical clinical manifestations with patches-to-plaques, tumors or erythroderma. Common histopathologic features in over half of the patients included epidermotropism, atypical lymphocytes, vacuolar interface changes, and Pautrier's microabscesses. Treatment modalities, including skin-directed and systemic therapies, primarily depended on the clinical staging. Age 65 years or over ( p = 0.004), and Stage IIB disease or higher ( p = 0.026) were significant contributors to disease-specific mortality. There was no significant sex difference in overall survival. Of the 22 patients, 36.3% had blood eosinophilia. Blood eosinophilia was associated with Stage II disease or higher ( p = 0.029) and an increased number of treatment types ( p = 0.018), but not lactate dehydrogenase (LDH). Age 65 years or over, Stage IIB disease or higher, and blood eosinophilia may be poor prognostic factors for Taiwanese patients with MF.