African American and Caucasian patients with Sézary syndrome have no differences in outcomes at an ethnically diverse urban medical center

Figures & data

Table 1. Comparison of descriptive statistics by race.

	Caucasian (n = 32)	AA (n = 28)	p-value
Demographics and baseline disease characteristics
Female gender	n = 9, 28.1%	n = 15, 53.6%	0.045*
Median age (years)	66.1	64.4	0.104
Median Sezary count at diagnosis (cells/L)^a	1926	1320	0.764
N0 stage at diagnosis	n = 9, 28.1%	n = 8,29.6%	0.899
+ TCR rearrangement (skin)^b	n = 13, 76.5%	n = 13, 81.3%	0.137
+ TCR rearrangement (blood)^c	n = 19, 82.6%	n = 15, 65.2%	0.208
Large cell transformation	n = 2, 6.3%	n = 6, 21.4%	0.084
CD7^− at diagnosis^d	n = 14, 77.8%	n = 16, 100%	0.045*
Median laboratory values at diagnosis
Hgb^e	14.3 g/dL	12.6 g/dL	0.036*
LDH^d	232 U/L	360 U/L	0.002*
WBC^f	16.0 × 10^3/µL	10.4 × 10^3/µL	0.849
ANC^e	5.33 × 10^3/µL	4.62 × 10^3/µL	0.450
AMC^e	1.01 × 10^3/µL	0.6 × 10^3/µL	0.061
Platelets^e	227 × 10^3/µL	278 × 10^3/µL	0.708
Albumin^d	3.8 g/dL	4.0 g/dL	0.503
Treatment and follow-up data
Received systemic therapy at any point	n = 27, 87.1%	n = 25, 92.6%	0.493
Median time from diagnosis to first systemic therapy	2.14 months	3.17 months	0.039*
Median total number of systemic therapies received	2.5	3.5	0.252
Received ECP at any point	n = 20, 64.5%	n = 11, 39.3%	0.053
Received HDACi at any point	n = 9, 28.1%	n = 18, 64.3%	0.005*
Received TSEB at any point	n = 11, 35.5%	n = 12, 42.9%	0.562
Dermatology follow-up**	n = 13, 54.2%	n = 14, 77.8%	0.114
Median OS	30.0 months	48.0 months	0.224
Median TTNT	6.6 months	5.8 months	0.181

AA: African American; TCR: T-cell receptor; Hgb: hemoglobin; LDH: lactate dehydrogenase WBC: white blood cell count; ECP: extracorporeal photopheresis; TSEB: Total skin electron beam radiation.

*Statistically significant at the level of p < 0.05.

**Defined as at least two outpatient visits for at least 1 year.

^aMissing data from 10 patients.

^bMissing data from 27 patients.

^cMissing data from 14 patients.

^dMissing data from 26 patients.

^eMissing data from 22 patients.

^fMissing data from 20 patients.

Table 2. Univariate and multivariable analysis of the association between select variables and clinical outcomes.

	OS		TTNT
	HR (CI)	p-value	HR (CI)	p-value
	Univariate association
Did not receive ECP at any time	1.67 (0.91–3.06)	0.098	1.65 (0.98–2.80)	0.062
No dermatology follow-up	2.75 (1.27–5.93)	0.010*	2.72 (1.34–5.51)	0.005*
	Multivariable analysis**
WBC (10^3 cells/µL)	1.05 (1.01–1.08)	0.01*	1.04 (1.002–1.08)	0.041*
LDH (units/L)	1.003 (1.001–1.005)	0.011*	1.002 (1.001–1.004)	0.048*

OS: overall survival; TTNT: time to next treatment; HR: hazard ratio; CI: 95% confidence interval; ECP: extracorporeal photopheresis; WBC: white blood cell count; LDH: lactate dehydrogenase.

*Statistically significant at the level of p < 0.05.

**WBC and LDH were analyzed as continuous variables. Number of observations in original data set = 62. Number of observations used in multivariable analysis = 29.

Figure 1. Kaplan–Meier curves for overall survival (OS) stratified by race.

Table 3. Distribution of treatment regimens received after diagnosis of Sézary syndrome.

Treatment regimen	First-line (n, %)			Any line (n, %)
	All patients n = 62*	Caucasian n = 32	African American n = 28	All patients n = 62	Caucasian n = 32	African American n = 28
Oral retinoids	29 (43.5%)	16 (40.6%)	13 (46.4%)	40 (64.5%)	22 (68.8%)	18 (64.3%)
Extracorporeal photopheresis (ECP)	20 (32.3%)	13 (40.6%)	6 (21.4%)	33 (53.2%)	21 (65.6%)	11 (39.3%)
Interferon	19 (30.6%)	13 (40.6%)	5 (17.9%)	31 (50.0%)	18 (56.3%)	13 (46.4%)
Methotrexate	6 (9.7%)	4 (12.5%)	2 (7.1%)	11 (17.7%)	6 (18.8%)	5 (17.9%)
Total skin electron beam (TSEB) radiation	5 (8.1%)	4 (12.5%)	1 (3.6%)	24 (38.7%)	11 (34.4%)	12 (42.3%)
Single agent chemotherapy	4 (6.5%)	0 (0.0%)	4 (14.3%)	11 (17.7%)	3 (9.4%)	8 (28.6)
Histone deacetylase inhibitor (HDACi)	3 (4.8%)	1 (3.1%)	2 (7.1%)	27 (46.8%)	9 (28.1%)	18 (64.3%)
Combination chemotherapy	3 (4.8%)	2 (6.2%)	1 (3.6%)	11 (17.7%)	6 (18.8%)	5 (17.9%)
Denileukin diftitox	1 (1.6%)	0 (0.0%)	1 (3.6%)	4 (6.5%)	1 (3.1%)	3 (10.7%)
Pralatrexate	0 (0%)	0 (0.0%)	0 (0.0%)	10 (16.1%)	4 (12.5%)	6 (21.4%)
Mogamulizumab	0 (0%)	0 (0.0%)	0 (0.0%)	4 (6.5%)	1 (3.1%)	3 (10.7%)
Brentuximab vedotin	0 (0%)	0 (0.0%)	0 (0.0%)	4 (6.5%)	2 (6.2%)	2 (7.1%)

HDACi: histone deacetylase inhibitor; ECP: extracorporeal photopheresis; TSEB: total skin electron beam.

*One patient was Asian and one had an unspecified race.

Figure 2. Kaplan–Meier curves for time from diagnosis to initiation of first systemic therapy stratified by race.

Data availability statement

Data were available within the article or its supplementary materials.