PROGNOSTIC FACTORS AND EVALUATION OF MYCOSIS-FUNGOIDES AND SEZARY-SYNDROME

Background: Staging evaluations of patients with mycosis fungoides (MF ) and Sezary syndrome (SS) are performed to individualize therapy and to predict survival. Objective: Our purpose was to determine the progn ostic factors in patients with MF and SS. Methods: A retrospective stu dy of 101 patients was performed. For inclusion in the study, patients had to have been evaluated for MF or SS within 6 months of the initia l definitive histologic diagnosis. The evaluation included physical ex amination, chest radiograph, peripheral blood smear, lymph node biopsy , bone marrow biopsy, gallium 67 scan. liver-spleen scan and computed tomography (CT) of the chest, abdomen, and pelvis. Results: The type o f skin disease present at initial diagnosis was a good prognostic indi cator of survival and clinical outcome. Univariate adverse prognostic features included hepatosplenomegaly or adenopathy by CT scan, abnorma l liver-spleen scan, abnormal gallium scan, adenopathy, and peripheral blood, bone marrow, and lymph node involvement. Independent prognosti c factors in multivariate analysis were the type of skin involvement a s well as peripheral blood and visceral involvement. Conclusion: Our s tudy confirms previous reports that type of skin and peripheral blood and visceral involvement are important prognostic factors in patients with MF or SS. Our results support the finding that patients with T1 s tage disease have an excellent survival outlook and clinical outcome.