Poor prognosis in non-Caucasian patients with early-onset mycosis fungoides

Background Mycosis fungoides (MF), the most common cutaneous T-cell lymphoma, is most often seen in middle-aged to elderly men. Objective We conducted a retrospective study of the demographics and prognosis of patients with onset of MF before age 40 years. Methods Demographic data (age, sex, and race) and histology from 1074 patents with cutaneous T-cell lymphoma were stratified by age of onset and race and analyzed using Chi-square test. Results Women presented before age 40 years more often than men ( P = .038). Early onset of MF was diagnosed in 30 of 92 (32.6%) African American (AA), 31 of 87 (35.6%) Hispanic, and 103 of 809 (12.7%) Caucasian patients. MF was significantly more common in AA ( P = .0008) and Hispanic ( P = .0002) patients. Early-onset MF was more common among 21 of 60 AA women (35%, P = .0174) and 19 of 40 Hispanic women (47.5%, P = .0002) than among 50 of 350 Caucasian women (14.5%). Progression from initial TNM stage occurred in only 5 (10%) Caucasian, one (5%) Hispanic, and 8 (38%) AA women who presented before age 40 years. Six of 8 AA women who progressed died of their disease whereas two were long-term survivors after allogeneic transplantation. Limitations This was a retrospective study at one cancer center. Conclusion Although MF is considered to be a disease of middle-aged men, early-onset MF is more common among AA and Hispanic women. AA women with early onset may have a poor prognosis and should be considered for more aggressive therapy, including allogeneic transplantation.