TY - JOUR
TI - Treatment of early-stage mycosis fungoides: results from the PROspective
Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study
AU - Quaglino, P.
AU - Prince, H. M.
AU - Cowan, R.
AU - Vermeer, M. and
AU - Papadavid, E.
AU - Bagot, M.
AU - Servitjie, O.
AU - Berti, E.
AU - Guenova,
AU - E.
AU - Stadler, R.
AU - Querfeld, C.
AU - Busschots, A. M.
AU - Hodak, E.
AU - and Patsatsi, A.
AU - Sanches, J.
AU - Maule, M.
AU - Yoo, J.
AU - Kevin, M.
AU - and Fava, P.
AU - Ribero, S.
AU - Zocchi, L.
AU - Rubatto, M.
AU - Fierro,
AU - M. T.
AU - Wehkamp, U.
AU - Marshalko, M.
AU - Mitteldorf, C.
AU - Akilov,
AU - O.
AU - Ortiz-Romero, P.
AU - Estrach, T.
AU - Vakeva, L.
AU - Enz, P. A.
AU - and Wobser, M.
AU - Bayne, M.
AU - Jonak, C.
AU - Rubeta, M.
AU - Forbes, A.
AU - and Bates, A.
AU - Battistella, M.
AU - Amel-Kashipaz, R.
AU - Vydianath,
AU - B.
AU - Combalia, A.
AU - Georgiou, E.
AU - Hauben, E.
AU - Hong, E. K. and
AU - Jost, M.
AU - Knobler, R.
AU - Amitay-Laish, I.
AU - Miyashiro, D. and
AU - Cury-Martins, J.
AU - Martinez, X.
AU - Muniesa, C.
AU - Prag-Naveh, H. and
AU - Stratigos, A.
AU - Nikolaou, V.
AU - Quint, K.
AU - Ram-Wolff, C. and
AU - Rieger, K.
AU - Stranzenbach, R.
AU - Szepesi, A.
AU - Alberti-Violetti, S.
AU - and Felicity, E.
AU - Cerroni, L.
AU - Kempf, W.
AU - Whittaker, S. and
AU - Willemze, R.
AU - Kim, Y.
AU - Scarisbrick, J. J.
JO - British Journal of Dermatology
PY - 2021
VL - 184
TODO - 4
SP - 722-730
PB - Wiley
SN - 0007-0963, 1365-2133
TODO - 10.1111/bjd.19252
TODO - null
TODO - Background The PROspective Cutaneous Lymphoma International Prognostic
Index (PROCLIPI) study is a prospective analysis of an international
database. Here we examine front-line treatments and quality of life
(QoL) in patients with newly diagnosed mycosis fungoides (MF).
Objectives To identify (i) differences in first-line approaches
according to tumour-nodes-metastasis-blood (TNMB) staging; (ii)
parameters related to a first-line systemic approach and (iii) response
rates and QoL measures.
Methods In total, 395 newly diagnosed patients with early-stage MF
(stage IA-IIA) were recruited from 41 centres in 17 countries between 1
January 2015 and 31 December 2018 following central clinicopathological
review.
Results The most common first-line therapy was skin-directed therapy
(SDT) (322 cases, 81 center dot 5%), while a smaller percentage (44
cases, 11 center dot 1%) received systemic therapy. Expectant
observation was used in 7 center dot 3%. In univariate analysis, the
use of systemic therapy was significantly associated with higher
clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA-IB vs. IIA, P < 0
center dot 001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0
center dot 001), higher modified Severity Weighted Assessment Tool (>
10, 15%; <= 10, 7%; P = 0 center dot 01) and folliculotropic MF (FMF)
(24% vs. 12%, P = 0 center dot 001). Multivariate analysis
demonstrated significant associations with the presence of plaques
(T1b/T2b vs. T1a/T2a, odds ratio 3 center dot 07) and FMF (odds ratio 2
center dot 83). The overall response rate (ORR) to first-line SDT was
73%, while the ORR to first-line systemic treatments was lower (57%)
(P = 0 center dot 027). Health-related QoL improved significantly both
in patients with responsive disease and in those with stable disease.
Conclusions Disease characteristics such as presence of plaques and FMF
influence physician treatment choices, and SDT was superior to systemic
therapy even in patients with such disease characteristics.
Consequently, future treatment guidelines for early-stage MF need to
address these issues.
ER -