A retrospective study of prognostic factors and treatment outcome in advanced-stage Mycosis Fungoides and Sezary Syndrome

Figures & data

Table 1. Clinical characteristics and follow-up data.

	Early Stage		Advanced Stage		P
	N = 39		N = 53
Gender
Male	16	41.0%	29	54.7%	0.21
Female	23	59.0%	24	45.3%
Age (years)
Average	47.65		50.64		0.82
Median	47		49.5
IQR (25%∼75%)	41.75∼54.75		41∼59.75
Classification
Classical MF	34	87.2%	36	67.9%	<0.01
Non-classical MF	5	12.8%	4	7.6%
Sezary syndrome	0	0.0%	13	24.5%
WBC (10^9/L)
Average	6.02		10.13		<0.01
Median	5.00		7.15
IQR (25%∼75%)	4.44∼6.94		5.97∼10.01
Lymphocyte (10^9/L)
Average	1.60		3.60		0.81
Median	1.54		1.44
IQR (25%∼75%)	1.10∼1.89		0.76∼2.35
Serum LDH (U/L)
Average	215.5		365.1		<0.01
Median	201.0		312.5
IQR (25%∼75%)	146.5∼244.5		216.5∼465.5
β2-MG (mg/L)
Average	2.25		4.08		<0.01
Median	2.14		3.60
IQR (25%∼75%)	1.62∼2.50		2.64∼4.88
First-line treatment
Skin-directed therapy	13	33.3%	0	0.0%	<0.01
Immunomodulatory therapy	26	66.7%	32	60.4%
Chemotherapy	0	0.0%	18	34.0%
HDAC inhibitors	0	0.0%	3	5.7%
Current status
Alive	38	97.4%	28	52.8%	<0.01
Dead	1	2.6%	25	47.2%
Survival
1-year OS	100.0%		92.0%		<0.01
5-year OS	97.1%		56.8%

IQR: Interquartile range.

Table 2. Prognostic analysis for OS.

Prognostic factors	OS (%)		Univariate			Multivariate
	1y	5y	HR	95%CI	P	HR	95%CI	P
Age (years)
<50	96.0%	74.7%
≥50	64.7%	37.9%	3.269	1.307∼8.179	0.011	2.76	0.848∼8.988	0.092
Classification
MF	94.2%	61.5%
SS	86.5%	53.1%	1.564	0.647∼3.784	0.321
Stage
IIB	100.0%	74.4%
IIIA	87.5%	60.0%	2.102	0.469∼9.425	0.332
IIIB	100.0%	50.0%	3.022	0.549∼16.63	0.204
IVA	83.3%	50.0%	3.120	0.910∼10.70	0.070	1.364	0.307∼6.069	0.683
IVB	72.9%	38.9%	4.354	1.166∼16.26	0.029	2.640	0.510∼13.659	0.274
WBC (10^9/L)
<8	100.0%	61.6%
≥8	88.9%	36.3%	2.583	1.068∼6.248	3.5%	1.576	0.534∼4.648	0.410
Serum LDH (U/L)
<250	93.8%	84.4%
≥250	90.1%	37.5%	7.248	1.684∼31.20	0.008	2.410	0.359∼16.164	0.365
β2-MG (mg/L)
<4.50	96.2%	58.6%
≥4.50	83.6%	37.1%	2.161	0.897∼5.211	0.086	3.213	1.143∼9.033	0.027

HR: Hazard ratio.

CI: Confidence interval.

Figure 1. Prognostic analysis for OS. A: Kaplan-Meier curves for each stage. B-E: Prognostic factors (age, WBC count, LDH, β2-MG) indicating differences in OS in patients with advanced-stage disease.

Figure 2. Prognostic analysis for PFS. A-D: Prognostic factors (age, WBC count, LDH, β2-MG) indicating differences in PFS in patients with advanced-stage disease.

Table 3. Prognostic analysis for PFS.

Prognostic factors	PFS		Univariate			Multivariate
	6m	12m	HR	95%CI	P	HR	95%CI	P
Age (years)
<50	92.3%	60.7%
≥50	44.3%	25.3%	2.289	1.164∼4.502	0.016	1.745	0.762∼3.995	0.188
Classification
MF	80.2%	49.4%
SS	42.9%	28.6%	1.608	0.766∼3.375	0.209
Stage
IIB	83.9%	66.2%
IIIA	75.0%	60.0%	1.434	0.526∼3.913	0.481
IIIB	NA	NA	4.748	0.58∼38.873	0.146
IVA	57.1%	24.5%	2.097	0.92∼4.781	0.078
IVB	62.5%	25.0%	2.305	0.822∼6.463	0.113
WBC (10^9/L)
<8	76.9%	51.4%
≥8	58.8%	43.6%	1.561	0.754∼3.233	0.231
Serum LDH (U/L)
<250	93.8%	67.0%
≥250	55.9%	38.7%	2.878	1.286∼6.438	0.010	2.687	1.124∼6.422	0.026
β2-MG (mg/L)
<4.50	76.0%	53.8%
≥4.50	50.8%	30.5%	1.554	0.705∼3.425	0.274

HR: Hazard ratio.

CI: Confidence interval.

Figure 3. Treatment outcomes in advanced-stage patients. A: Mean PFS ± CI for each treatment group. B: PFS curves for each treatment groups. P < 0.01 (log rank comparison). C: Mean OS ± CI for each treatment group. D: OS curves for each treatment groups. P = 0.03 (log rank comparison).

Table 4. Response and survival of different treatments in advanced-stage patients.

First-line therapy	Response rate (%)	Median OS (m)	OS (%)		Median PFS (m)	PFS (%)
			1y	5y		6m	12m
Immunomodulatory therapy	70.00%	NR	96.90%	71.50%	24	86.10%	64.90%
Chemotherapy	38.46%	39.5	81.00%	40.50%	5	42.40%	18.20%
HDAC inhibitor	33.33%	30	100.00%	33.30%	12	66.70%	0%

NR: not reached.

Data availability statement

The datasets analyzed for this study can be found in supplementary Table S2.