Ortiz Romero P L, Kim Y H, Molloy K, Quaglino P, Scarisbrick J, Thornton S, Sandilands K, Dent J E, Nixon A, Williams A, Shinohara M M
Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain.
Stanford University School of Medicine and Cancer Institute, Stanford, CA, USA.
J Eur Acad Dermatol Venereol. 2025 Apr;39(4):833-845. doi: 10.1111/jdv.20357. Epub 2024 Sep 24.
Mycosis fungoides (MF) and Sézary syndrome (SS) are common subtypes of cutaneous T-cell lymphoma that primarily affect the skin but may spread to the lymph nodes, viscera and blood. The symptom burden may compromise health-related quality of life (HRQL). The phase 3 MAVORIC study (ClinicalTrials.gov identifier NCT01728805) in patients with relapsed/refractory MF/SS reported improved HRQL with mogamulizumab compared with vorinostat.
Use baseline (pre-treatment) data from the MAVORIC study to describe the symptom burden of MF/SS and identify characteristics associated with worse HRQL.
Data were from 372 adults with stage IB-IVB histologically confirmed relapsed/ refractory MF or SS. Associations between demographic and medical history variables and worse HRQL (Skindex-29, ItchyQol and Functional Assessment of Cancer Therapy - General [FACT-G]) were determined by regression models.
In the cohort of 372 adults, 70% were white; 42% were female; mean age was 63 (SD 13.0) years. Fifty-five per cent had MF and 45% had SS; 77% had advanced (stage IIB-IV) disease, involving the skin in all patients and the blood and/or nodes in 66%. HRQL scores showed impairment versus normative means (where available), with the greatest impact on Symptoms and Emotions in the Skindex-29, Functioning in the ItchyQol, and Functional Wellbeing in the FACT-G. In regression analysis, worse HRQL across all domains and total score was associated with being female and younger, worse mSWAT score and worse itch for the Skindex-29 (n = 352), and being female, younger, Black/African American, worse performance status and worse itch for the ItchyQol (n = 369). Associations across domains and total score were not found for the FACT-G. Associations between domains and demographic/medical history were seen for all instruments.
The symptoms of advanced MF/SS compromise all HRQL domains. Treatment goals and therapeutic choice should be informed by individual patients' disease burden.
蕈样肉芽肿(MF)和 Sézary 综合征(SS)是皮肤 T 细胞淋巴瘤的常见亚型,主要累及皮肤,但可能扩散至淋巴结、内脏和血液。症状负担可能会损害健康相关生活质量(HRQL)。针对复发/难治性 MF/SS 患者的 3 期 MAVORIC 研究(ClinicalTrials.gov 标识符 NCT01728805)报告称,与伏立诺他相比,莫加莫单抗可改善 HRQL。
使用 MAVORIC 研究的基线(治疗前)数据来描述 MF/SS 的症状负担,并确定与较差 HRQL 相关的特征。
数据来自 372 名经组织学确诊为 IB-IVB 期复发/难治性 MF 或 SS 的成年人。通过回归模型确定人口统计学和病史变量与较差 HRQL(Skindex-29、ItchyQol 和癌症治疗功能评估-通用版 [FACT-G])之间的关联。
在这 372 名成年人队列中,70% 为白人;42% 为女性;平均年龄为 63(标准差 13.0)岁。55% 患有 MF,45% 患有 SS;77% 患有晚期(IIB-IV 期)疾病,所有患者均累及皮肤,66% 累及血液和/或淋巴结。HRQL 评分显示与正常均值相比存在损害(如可获取),对 Skindex-29 中的症状和情绪、ItchyQol 中的功能以及 FACT-G 中的功能幸福感影响最大。在回归分析中,所有领域和总分的较差 HRQL 与女性、年轻、Skindex-29 的 mSWAT 评分较差和瘙痒较重相关(n = 352),与女性、年轻、黑人/非裔美国人、表现状态较差和 ItchyQol 的瘙痒较重相关(n = 369)。FACT-G 未发现各领域与总分之间的关联。所有工具均可见各领域与人口统计学/病史之间的关联。
晚期 MF/SS 的症状损害了所有 HRQL 领域。治疗目标和治疗选择应根据个体患者的疾病负担来确定。