Should we be evaluating blood involvement in early-stage paediatric mycosis fungoides? A retrospective cohort analysis using flow cytometry

Clin Exp Dermatol. 2025 Oct 27;50(11):2259-2262. doi: 10.1093/ced/llaf340.

Abstract

Flow cytometry is a standard tool for blood involvement classification in mycosis fungoides (MF). However, data are lacking for paediatric patients, who primarily exhibit early-stage disease. We retrospectively analysed flow cytometry results from 65 paediatric patients with early-stage MF. All were classified as B0 or B1, indicating no or low-level blood involvement, respectively. None met the B2 criteria. B1 rates were 34% and 49%, based on percentage and absolute count criteria of CD4+/CD7- or CD4+/CD26-, respectively. These rates are markedly higher than previously reported for adult MF. B status was not correlated with demographic or clinical findings. During a mean (SD) follow-up of 5.6 (4.0) years, none of the patients had stage progression. Our cohort's frequent B1 classification in early-stage paediatric MF suggests that a reassessment of the criteria defining B0 and B1 may be necessary. Furthermore, considering the benign course of paediatric MF, the clinical significance of B status assessment warrants further investigation.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Flow Cytometry / methods
  • Humans
  • Infant
  • Male
  • Mycosis Fungoides* / blood
  • Mycosis Fungoides* / pathology
  • Retrospective Studies
  • Skin Neoplasms* / blood
  • Skin Neoplasms* / pathology