Validity assessment of the cutaneous T-cell lymphoma severity index to predict prognosis in advanced mycosis fungoides/Sézary syndrome

Evans, Katherine G.; Troxel, Andrea B.; DeNardo, Barbara J.; Introcaso, Camille E.; Rook, Alain H.; Kim, Ellen J.

doi:10.1016/j.jaad.2009.01.044

Cited by 16 publications

(9 citation statements)

References 20 publications

(26 reference statements)

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“…In 1997, a German group proposed the use of a CTCL severity index (CTCL‐SI) as a quantitative measure of disease severity based on the extent of skin, tumour, lymph node, blood and visceral involvement. The CTCL‐SI may represent a useful adjunct to TNMB staging for quantitative tracking of disease activity and may provide superior prognostic information to TNMB . This severity index includes a measure of skin involvement with CTCL, which had prognostic significance in univariate analysis, but only blood and lymph node involvement were significant in multivariate analysis, not skin or viscera .…”

Section: Review Of Parameters Relevant To Prognosis In Mycosis Fungoimentioning

confidence: 99%

Prognostic factors, prognostic indices and staging in mycosis fungoides and Sézary syndrome: where are we now?

Kim²,

et al. 2014

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Mycosis fungoides is the most prevalent form of primary cutaneous T-cell lymphoma. Patients frequently present with early-stage disease typically associated with a favourable prognosis and survival of 10-35 years, but over 25% may progress to advanced disease with a median survival < 4 years, and just 13 months in those with nodal involvement. Sézary syndrome presents in advanced disease with erythroderma, blood involvement and lymphadenopathy. The Bunn and Lamberg staging system (1979) includes stages IA-IIA (early-stage disease) and IIB-IVB (advanced-stage disease) and provides prognostic information, but some patients with tumour-stage disease (IIB) have a worse prognosis than those with erythrodermic-stage (III). Conversely, patients with plaque-stage (IB) folliculotropic mycosis fungoides may have a worse outcome than those with tumour-stage (IIB). The more recent staging system of the European Organisation for the Research and Treatment of Cancer/International Society for Cutaneous Lymphoma has been designed to reflect tumour burden at different sites. However, this staging system has not been validated prospectively for prognosis. Furthermore, this staging system does not include a detailed measurement of skin tumour burden, as indicated by the modified skin weighted severity assessment tool. This assessment measures body surface area of disease and is weighted to record patch, plaque and tumour to produce a numerical value from 0·5 to 400 and is an established endpoint for clinical studies. Nor does this staging include clinicopathological features associated with a poor prognosis such as folliculotropism. Here we review the clinical, haematological, pathological and genotypic parameters outside the staging system, which may affect survival in mycosis fungoides and Sézary syndrome. Most studies are retrospective and single centre. The identification of poor prognostic factors may be used to develop a prognostic index to use alongside staging, which may be of benefit in mycosis fungoides/Sézary syndrome to identify patients with a potentially poor prognosis.

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Section: Review Of Parameters Relevant To Prognosis In Mycosis Fungoimentioning

confidence: 99%

Prognostic factors, prognostic indices and staging in mycosis fungoides and Sézary syndrome: where are we now?

Kim²,

et al. 2014

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“…The median overall survival (OS) in advanced‐stage disease was five years. The median OS from diagnosis of large cell transformation was two years 12,13 . Therefore, large cell transformation represents a more serious constellation than advanced‐stage disease.…”

Section: Major Clinical Subtypesmentioning

confidence: 99%

“…Whereas patients in early‐stage MF have a normal life expectancy, five‐year survival has been estimated at 70% in stage IIa, 48% in stages IIb–IIIb, and 36% in stage IV 13,14 …”

Section: Major Clinical Subtypesmentioning

confidence: 99%

Cutaneous T cell lymphoma: update on treatment

Wollina

2012

Int J Dermatology

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“…To date there have been no reported prospective studies analyzing predictive factors, although some studies have advocated the use of disease severity scoring systems as a means for predicting prognosis independent of TNMB staging. 18,20 The classification of MF and SS has been modified throughout the years. Patients who were seen more recently have received a more thorough workup including advanced imaging with computed tomographic (CT) and positronemission tomography CT scans that were not available to patients seen in the earlier years.…”

Section: Commentmentioning

confidence: 99%