Prevalence and severity of pruritus in cutaneous T cell lymphoma

Abstract

The most common types of cutaneous T cell lymphoma (CTCL) are mycosis fungoides (MF) and its leukemic variant, Sézary syndrome (SS). One of the hallmarks of MF and SS is pruritus that rarely responds to treatment. Little is known about the prevalence and severity of pruritus in MF and SS. A retrospective analysis was performed to assess the prevalence and severity of pruritus in MF and SS. This study compared self-reported pruritus in early-stage (stage Ia-IIa) and late-stage (stage IIb-IVb) disease, and in MF and SS, in patients presenting at our CTCL clinic between January 1, 2006, and June 30, 2010. Of the 551 eligible patients, 486 reported baseline pruritus values. Overall, 373 patients had early-stage disease, 113 had late-stage disease, and 72 had SS. The prevalence of pruritus was 66% in all patients, 62% in patients with early-stage disease, 83% in those with late-stage disease, 61% in those with MF, and 94% in those with SS. Mean pruritus values out of 10 were: 4.2 [standard error of the mean (SEM) = 0.18] in all patients; 3.4 (SEM = 0.19) in patients with early-stage disease; 6.6 (SEM = 0.36) in those with late-stage disease; 3.6 (SEM = 0.18) in MF patients, and 7.7 (SEM = 0.37) in SS patients. Differences between early- and late-stage disease, and MF and SS, were statistically significant (P < 0.001). Pruritus affects a large proportion of patients with CTCL and is significantly more severe in late- than in early-stage disease and in SS than in MF. Little information exists on the full range of the symptom burden on the patient. This aspect of patient care requires further exploration.