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.