The Second Xiangya Hospital, Central South University, Department of Dermatology, Changsha, Hunan, China.
Yale School of Medicine, New Haven, CT, USA.
Br J Haematol. 2018 Jun;181(6):752-759. doi: 10.1111/bjh.15222. Epub 2018 Apr 20.
Primary cutaneous CD30 T cell lymphoproliferative disorders (PCLPD), the second most common type of primary cutaneous T cell lymphomas, accounts for approximately 25-30% of cutaneous T-cell lymphoma cases. However, only small retrospective studies have been reported. We aimed to identify prognostic factors and evaluate the overall survival (OS) of patients with PCLPD stratified by ethnicity. We identified 1496 patients diagnosed with PCLPD between 2004 and 2014 in the US National Cancer Database. Chi-square test and anova were used to evaluate differences in demographic and disease characteristics, socioeconomic factors and treatments received. OS was evaluated with the log-rank test, Cox proportional hazard regression analysis, and propensity score matching. The study included 1267 Caucasians, 153 African Americans (AA), 43 Asians, and 33 of other/unknown ethnicity. Older age, higher Charlson-Deyo score, higher clinical stage and receipt of chemotherapy were predictors of shorter OS. Primary disease site on a lower extremity was associated with shorter OS, while a head and neck location was associated with longer OS. AA patients had shorter OS when compared to Caucasian patients on multivariate analysis. This ethnic disparity persisted on propensity-score matched analysis and after matching Caucasian and AA patients on demographic and disease characteristics, socioeconomic factors and treatments received, and age and gender-matched relative survival analyses.
原发性皮肤 CD30T 细胞淋巴增生性疾病(PCLPD)是原发性皮肤 T 细胞淋巴瘤的第二大常见类型,约占皮肤 T 细胞淋巴瘤病例的 25-30%。然而,仅有少数回顾性研究进行了报道。我们旨在确定 PCLPD 的预后因素,并按种族分层评估患者的总生存率(OS)。我们在 2004 年至 2014 年间从美国国家癌症数据库中确定了 1496 例诊断为 PCLPD 的患者。使用卡方检验和方差分析评估人口统计学和疾病特征、社会经济因素和治疗方法的差异。使用对数秩检验、Cox 比例风险回归分析和倾向评分匹配评估 OS。该研究包括 1267 名白种人、153 名非裔美国人(AA)、43 名亚洲人和 33 名其他/未知种族的患者。年龄较大、Charlson-Deyo 评分较高、临床分期较高和接受化疗是 OS 较短的预测因素。下肢原发性疾病部位与 OS 较短相关,而头颈部位置与 OS 较长相关。多变量分析显示,与白种人患者相比,AA 患者的 OS 较短。在倾向评分匹配分析以及在匹配白种人和 AA 患者的人口统计学和疾病特征、社会经济因素和治疗方法、年龄和性别匹配相对生存率分析后,这种种族差异仍然存在。