Mycosis Fungoides and Associated Malignancies in a Dutch Nationwide Retrospective Cohort Study
DOI:
https://doi.org/10.2340/actadv.v104.40065Keywords:
concomitant malignancies, cutaneous T-cell lymphoma, epidemiology, folliculotropic mycosis fungoides, mycosis fungoidesAbstract
The prognosis of patients with mycosis fungoides is variable. As the current literature is scarce and shows mixed results this study investigates the incidence of other primary malignancies in mycosis fungoides patients. A retrospective, nationwide, population- based cohort study was performed with patients with mycosis fungoides between 2000 and 2020 in The Netherlands. All histopathology reports were requested from the Nationwide Network and Registry of Histo- and Cytopathology and screened for other primary malignancies. Lifelong incidence rates were used to compare the incidence of malignancies in mycosis fungoides patients and the general population. In total 1,024 patients were included with a mean follow-up of 10 years (SD 6). A total of 294 cases of other primary malignancies were found with 29% of the mycosis fungoides patients developing at least 1 other primary malignancy. Only cutaneous (odds ratio [OR] 2.54; CI 2.0–3.2) and haematological malignancies (OR 2.62; CI 2.00–3.42) had a statistically significant higher incidence than the Dutch population overall. Mycosis fungoides patients have a significantly increased risk of developing melanomas (OR 2.76; CI 2.11–3.59) and cutaneous squamous cell carcinomas mycosis fungoides (OR 2.34; CI 1.58–3.45). This study shows no association between mycosis fungoides and other solid organ tumours; however, such patients are significantly at risk of developing other haematological and cutaneous malignancies. Clinicians should be aware of this increased risk.
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Willemze R, Jaffe ES, Burg G, Cerroni L, Berti E, Swerdlow SH, et al. WHO-EORTC classification for cutaneous lymphomas. Blood 2005; 105: 3768-3785.
https://doi.org/10.1182/blood-2004-09-3502 DOI: https://doi.org/10.1182/blood-2004-09-3502
Ottevanger R, de Bruin DT, Willemze R, Jansen PM, Bekkenk MW, de Haas ERM, et al. Incidence of mycosis fungoides and Sezary syndrome in the Netherlands between 2000 and 2020. Br J Dermatol 2021; 185: 434-435.
https://doi.org/10.1111/bjd.20048 DOI: https://doi.org/10.1111/bjd.20048
Kaufman AE, Patel K, Goyal K, O'Leary D, Rubin N, Pearson D, et al. Mycosis fungoides: developments in incidence, treatment and survival. J Eur Acad Dermatol Venereol 2020; 34: 2288-2294.
https://doi.org/10.1111/jdv.16325 DOI: https://doi.org/10.1111/jdv.16325
Alsayyah A. Is it mycosis fungoides? A comprehensive guide to reaching the diagnosis and avoiding common pitfalls. Ann Diagn Pathol 2020; 47: 151546.
https://doi.org/10.1016/j.anndiagpath.2020.151546 DOI: https://doi.org/10.1016/j.anndiagpath.2020.151546
Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, et al. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181: 350-357.
https://doi.org/10.1111/bjd.17258 DOI: https://doi.org/10.1111/bjd.17258
Cengiz FP, Emiroglu N, Onsun N. Frequency and risk factors for secondary malignancies in patients with mycosis fungoides. Turk J Haematol 2017; 34: 378-379.
https://doi.org/10.4274/tjh.2017.0234 DOI: https://doi.org/10.4274/tjh.2017.0234
Goyal A, O'Leary D, Goyal K, Rubin N, Bohjanen K, Hordinsky M, et al. Increased risk of second primary hematologic and solid malignancies in patients with mycosis fungoides: a Surveillance, Epidemiology, and End Results analysis. J Am Acad Dermatol 2020; 83: 404-411.
https://doi.org/10.1016/j.jaad.2019.07.075 DOI: https://doi.org/10.1016/j.jaad.2019.07.075
Hodak E, Lessin S, Friedland R, Freud T, David M, Pavlovsky L, et al. New insights into associated co-morbidities in patients with cutaneous t-cell lymphoma (mycosis fungoides). Acta Derm-Venereol 2013; 93: 451-455.
https://doi.org/10.2340/00015555-1496 DOI: https://doi.org/10.2340/00015555-1496
Huang KP, Weinstock MA, Clarke CA, McMillan A, Hoppe RT, Kim YH. Second lymphomas and other malignant neoplasms in patients with mycosis fungoides and Sezary syndrome: evidence from population-based and clinical cohorts. Arch Dermatol 2007; 143: 45-50.
https://doi.org/10.1001/archderm.143.1.45 DOI: https://doi.org/10.1001/archderm.143.1.45
Lindahl LM, Fenger-Gron M, Iversen L. Subsequent cancers, mortality, and causes of death in patients with mycosis fungoides and parapsoriasis: a Danish nationwide, population-based cohort study. J Am Acad Dermatol 2014; 71: 529-535.
https://doi.org/10.1016/j.jaad.2014.03.044 DOI: https://doi.org/10.1016/j.jaad.2014.03.044
Evans AV, Scarisbrick JJ, Child FJ, Acland KM, Whittaker SJ, Russell-Jones R. Cutaneous malignant melanoma in association with mycosis fungoides. J Am Acad Dermatol 2004; 50: 701-705.
https://doi.org/10.1016/j.jaad.2003.11.054 DOI: https://doi.org/10.1016/j.jaad.2003.11.054
Goyal A, O'Leary D, Goyal K, Patel K, Pearson D, Janakiram M. Cutaneous T-cell lymphoma is associated with increased risk of lymphoma, melanoma, lung cancer, and bladder cancer. J Am Acad Dermatol 2021; 85: 1418-1428.
https://doi.org/10.1016/j.jaad.2020.06.1033 DOI: https://doi.org/10.1016/j.jaad.2020.06.1033
Melchers RC, Willemze R, Bekkenk MW, de Haas ERM, Horvath B, van Rossum MM, et al. Frequency and prognosis of associated malignancies in 504 patients with lymphomatoid papulosis. J Eur Acad Dermatol Venereol 2020; 34: 260-266.
https://doi.org/10.1111/jdv.16065 DOI: https://doi.org/10.1111/jdv.16065
Casparie M, Tiebosch AT, Burger G, Blauwgeers H, van de Pol A, van Krieken JH, et al. Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive. Cell Oncol 2007; 29: 19-24.
https://doi.org/10.1155/2007/971816 DOI: https://doi.org/10.1155/2007/971816
IKNL [Internet]. Netherlands Comprehensive Cancer Organisation (IKNL) 2022. Available from: https://iknl.nl/home.
Statistics Netherlands; Population on January 1st and average: sex, age, region. Central Bureau for Statistics, 2022. Available from: https://www.cbs.nl/.
Corp. I. IBM SPSS Statistics for Windows. 25.0 ed. Armonk, NY; IBM Corp.; 2017.
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453-1457.
https://doi.org/10.1016/S0140-6736(07)61602-X DOI: https://doi.org/10.1016/S0140-6736(07)61602-X
Pielop JA, Brownell I, Duvic M. Mycosis fungoides associated with malignant melanoma and dysplastic nevus syndrome. Int J Dermatol 2003; 42: 116-122.
https://doi.org/10.1046/j.1365-4362.2003.01697.x DOI: https://doi.org/10.1046/j.1365-4362.2003.01697.x
Miyatake J, Inoue H, Serizawa K, Morita Y, Espinoza JL, Tanaka H, et al. Synchronous occurrence of mycosis fungoides, diffuse large B cell lymphoma and acute myeloid leukemia. Intern Med 2018; 57: 1445-1453.
https://doi.org/10.2169/internalmedicine.9668-17 DOI: https://doi.org/10.2169/internalmedicine.9668-17
Scheu A, Schnabl SM, Steiner DP, Fend F, Berneburg M, Yazdi AS. Importance of diagnostics and risk of secondary malignancies in primary cutaneous lymphomas. J Dtsch Dermatol Ges 2021; 19: 373-381.
https://doi.org/10.1111/ddg.14400 DOI: https://doi.org/10.1111/ddg.14400
Cieza-Diaz DE, Prieto-Torres L, Rodriguez-Pinilla SM, Cordoba Mascunano R, Manso Alonso R, Machan S, et al. Mycosis fungoides associated with lesions in the spectrum of primary cutaneous CD30+ lymphoproliferative disorders: the same process or 3 coexisting lymphomas? Am J Dermatopathol 2019; 41: 846-850.
https://doi.org/10.1097/DAD.0000000000001423 DOI: https://doi.org/10.1097/DAD.0000000000001423
Chott A, Vonderheid EC, Olbricht S, Miao NN, Balk SP, Kadin ME. The dominant T cell clone is present in multiple regressing skin lesions and associated T cell lymphomas of patients with lymphomatoid papulosis. J Invest Dermatol, 1996; 106: 696-700.
https://doi.org/10.1111/1523-1747.ep12345532 DOI: https://doi.org/10.1111/1523-1747.ep12345532
Le K, Lim A, Samaraweera U, Morrow C, See A. Multiple squamous cell carcinomas in a patient with mycosis fungoides. Australas J Dermatol 2005; 46: 270-273.
https://doi.org/10.1111/j.1440-0960.2005.00198.x DOI: https://doi.org/10.1111/j.1440-0960.2005.00198.x
Schreuder K, Hollestein L, Nijsten TEC, Wakkee M, Louwman MWJ. A nationwide study of the incidence and trends of first and multiple basal cell carcinomas in the Netherlands and prediction of future incidence. Br J Dermatol 2022; 186: 476-484.
https://doi.org/10.1111/bjd.20871 DOI: https://doi.org/10.1111/bjd.20871
Reseghetti A, Tribbia G, Locati F, Naldi L, Marchesi L. Cutaneous malignant melanoma appearing during photochemotherapy of mycosis fungoides. Dermatology 1994; 189: 75-77.
https://doi.org/10.1159/000246790 DOI: https://doi.org/10.1159/000246790
Venables ZC, Autier P, Nijsten T, Wong KF, Langan SM, Rous B, et al. Nationwide incidence of metastatic cutaneous squamous cell carcinoma in England. JAMA Dermatol 2019; 155: 298-306.
https://doi.org/10.1001/jamadermatol.2018.4219 DOI: https://doi.org/10.1001/jamadermatol.2018.4219
Shah R, Patel N, Patel Y, Toscani M, Barone J, Weber PF. Age demographics of subjects enrolled in global, interventional Phase 3 melanoma clinical trials. Ther Innov Regul Sci 2022; 56: 184-190.
https://doi.org/10.1007/s43441-021-00362-0 DOI: https://doi.org/10.1007/s43441-021-00362-0
Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome): part I. Diagnosis; clinical and histopathologic features and new molecular and biologic markers. J Am Acad Dermatol 2014; 70: 205 e1-16; quiz 21-22.
https://doi.org/10.1016/j.jaad.2013.07.049 DOI: https://doi.org/10.1016/j.jaad.2013.07.049
Goyal A, O'Leary D, Goyal K, Rubin N, Janakiram M. Screening for second malignancies in mycosis fungoides: non-Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, bladder cancer and melanoma. J Eur Acad Dermatol Venereol 2021; 35: 1821-1829.
https://doi.org/10.1111/jdv.17384 DOI: https://doi.org/10.1111/jdv.17384
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Copyright (c) 2024 Rosanne Ottevanger, Esther Vermaas, Rein Willemze, Anne-Roos Schrader, Patty M. Jansen, Jelle J. Goeman, Hein Putter, Maarten H. Vermeer, Koen D. Quint
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