Racial Disparities in Mycosis Fungoides/Sézary Syndrome-A Single-Center Observational Study of 292 Patients

Clin Lymphoma Myeloma Leuk. 2024 Apr;24(4):e174-e180. doi: 10.1016/j.clml.2023.12.017. Epub 2024 Jan 3.

Abstract

Background: Clinical presentation of Mycosis fungoides/Sézary syndrome (MF/SS) in Black and African American (AA) patients can be heterogeneous with poor survival reported in AA/black patients. In this study, we aim to characterize differences between AA/black and white patients with MF/SS.

Patients and methods: A retrospective single-center hospital-based case-control study including 292 MF/SS patients (146 AA/black matched with 146 white patients). We analyzed demographic, clinical and survival differences.

Results: AA/black patients were diagnosed at an earlier age (9 years younger), were predominantly females, had higher rates of Medicaid/Medicare insurance and lower income compared to matched white patients (P <.001). Adjusting for age, sex, insurance type, and income bracket, AA/black patients had significantly worse overall survival (hazard ratio [HR] 2.88, 95%CI 1.21-6.85, P = .017). Association of clinical MF phenotype with survival showed that hypopigmentation was associated with survival in AA/black patients but not in white patients. Erythroderma and ulceration were associated with worse survival risk in AA/black patients.

Conclusions: AA/black patients with MF/SS have a significant worse survival outcome compared to white patients. The association between clinical phenotypes and survival differed between these groups. Further studies are required to investigate whether race-specific pathogenesis or genetic factors may explain these differences.

Keywords: African American; CTCL; Cutaneous lymphoma; MF; Racial disparity; Skin of color; Survival analysis.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Case-Control Studies
  • Female
  • Humans
  • Lymphoma, T-Cell, Cutaneous* / pathology
  • Male
  • Medicare
  • Mycosis Fungoides* / diagnosis
  • Retrospective Studies
  • Sezary Syndrome*
  • Skin Neoplasms* / diagnosis
  • United States / epidemiology