Evaluation of clinical, laboratory findings and treatment results of mycosis fungoides patients: A single center retrospective study

Mycosis fungoides (MF), is the most common clinical form of primary cutaneous T-cell lymphomas. The reported incidence of MF ranges between 1 in 100.000 and 6,5 in 1 million, making it relatively rare, slow-progressing disease. Diagnosis in the early stages is challenging due to subtle immunohistopathologic findings and its ability to clinically and pathologically mimic various dermatoses. Despite the establishment of early MF diagnostic criteria, diagnosis in many patients is clarified only through multiple repeat skin biopsies over prolonged follow-up periods. Treatment and follow-up of patients are managed within the framework of available guidelines, tailored to patient and clinical resources. While the disease generally remains stable, systemic progression is rare. Although various parameters and indices are used to predict relapse and progression, a unified approach has yet to be established. This study aims to document the demographic, clinical, morphological features, laboratory parameters, and treatments of early MF patients followed in our clinic and to evaluate the relationship of these data with treatment response, recurrence, progression and survival. Our study included patients diagnosed or followed up between August 2013 and August 2023 at Tokat Gaziosmanpaşa University Faculty of Medicine, Dermatology Clinic. Of the 47 patients who met the criteria and whose retrospective data were available, 25 (51%) were female, and 23 (49%) were male. The mean age at diagnosis was 46,49 years, ranging from 21 to 68 yeras. A total of 42 (86,36%) patients were diagnosed before age 60, while 5 (10,64%) were diagnosed after age 60. The mean follow-up duration was 7,13 years, with a minimum of 1 year and a maximum of 20 years. The mean age of diagnosis for males (50,91) was significantly higher than that for females (42,25), and the mean follow-up period for males (8,83 years) was significantly longer than that for females (5,5 years). At diagnosis, 29 (61,7%) patients were stage IA, 16 (34,04%) were stage IB, and 2 (4,26%) were stage IIA. As initial treatment, 41 patients (87,24%) received skin-directed therapy, while 6 patients (12,76%) received combined systemic and skin-directed therapies. A complete response to initial treatment was achieved in 24 (51,1%) patients. Patch plaque morphology, initial lymph node stage of N0/Nx, and Cutaneous Lymphoma International Prognostic Index (CLIPi) score were associated with treatment response. A shorter time between lesion onset and consultation with a physician was associated vii with disease-free survival. In conclusion, our study has revealed findings that may aid in assessing early MF patients, predicting treatment response, and guiding patient management. Keywords: Mycosis Fungoides, Early stage, Treatment, Survival