A case-control study of clinicopathologic features, prognosis, and therapeutic responses in patients with granulomatous mycosis fungoides Journal Article
| Authors: | Li, J. Y.; Pulitzer, M. P.; Myskowski, P. L.; Dusza, S. W.; Horwitz, S.; Moskowitz, A.; Querfeld, C. |
| Article Title: | A case-control study of clinicopathologic features, prognosis, and therapeutic responses in patients with granulomatous mycosis fungoides |
| Abstract: | Background: Granulomatous mycosis fungoides (GMF) is an uncommon variant of mycosis fungoides (MF). Objective: We sought to analyze the relative frequency, clinicopathologic characteristics, prognosis, and therapeutic responses of GMF. Methods: We conducted a retrospective case-control study of patients with GMF and age- and stage-matched patients with classic MF between 1981 and 2012. Results: A total of 27 patients with GMF were identified, representing 6.3% of all patients with MF at our center. Skin manifestations were similar to classic MF having an atypical lichenoid CD4+ CD8- lymphocytic infiltrate with interstitial histiocytes and/or perivascular granulomas with giant cells. Fewer patients with GMF achieved a partial response or complete response with topical (57% vs 83%; P =.002) or ultraviolet light (62% vs 90%; P =.006) therapy. The 5- and 10-year progression-free survival rates were significantly lower in patients with GMF (59% and 33%) compared with patients with classic MF (84% and 56%; P =.02), but overall survival was similar between groups (86% and 72% vs 85% and 85%; P =.54). Limitations: The retrospective methodology may underestimate the frequency of GMF. The median follow-up time may be too short to detect possible differences in overall survival. Conclusion: More frequent disease progression and poorer response to skin-directed therapies were observed in patients with GMF. Our findings may be helpful in selecting the most appropriate treatment for these patients. © 2013 by the American Academy of Dermatology, Inc. |
| Keywords: | adult; clinical article; controlled study; human tissue; treatment outcome; treatment response; aged; overall survival; case control study; prednisone; clinical feature; histopathology; doxorubicin; gemcitabine; ultraviolet radiation; progression free survival; incidence; cyclophosphamide; vincristine; chlormethine; cutaneous t-cell lymphoma; electron therapy; cd4+ cd25+ t lymphocyte; disease progression; outcome; lymphocytic infiltration; corticosteroid; navelbine; giant cell; mycosis fungoides; pralatrexate; alemtuzumab; cladribine; denileukin diftitox; zanolimumab; bexarotene; cancer prognosis; granulomatous mycosis fungoides; lichenoid; skin granuloma |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 69 |
| Issue: | 3 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2013-09-01 |
| Start Page: | 366 |
| End Page: | 374.e4 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2013.03.036 |
| PROVIDER: | scopus |
| PUBMED: | 23685027 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: JAADD" - "Source: Scopus" |
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