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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/221606
Análisis de supervivencia y factores pronósticos en una serie de 148 casos de linfomas cutáneos de células T
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[spa] Antecedentes y objetivo
Los linfomas cutáneos de células T (LCCT) como la micosis fungoide (MF) y el síndrome de Sézary (SS) son linfomas poco comunes con pronósticos variables. El objetivo del estudio fue describir la supervivencia de una cohorte de pacientes con MF/SS y evaluar aquellos factores pronósticos con impacto en la supervivencia de la enfermedad.
Material y métodos
Se analizaron retrospectivamente todos los casos diagnosticados de MF/SS entre 2008 y 2022. Se evaluaron variables demográficas, parámetros histológicos, y datos analíticos. Se calcularon la supervivencia libre de progresión (PFS) y la supervivencia específica de la enfermedad (DSS).
Resultados
Se incluyeron un total de 148 casos. Ciento veintiún casos (82%) fueron diagnosticados de MF y 27 casos de SS. Treinta y siete pacientes (25%) progresaron en algún momento de la evolución. La mediana de PFS fue de 127 meses y la mediana de DSS de 135 meses. La edad > 60 años, el diagnóstico de SS, la presencia de transformación a célula grande (TCG) al diagnóstico, el foliculotropismo en estadios iniciales, la elevación de Ki-67, la presencia de TCR clonal en sangre, niveles elevados de LDH y B2M, y estadios avanzados (IIB, IVA, T3, T4, N3/Nx) se asociaron con un peor pronóstico en la cohorte.
Conclusiones
El estadio IVA y la presencia de TCG al diagnóstico destacaron como factores independientes de pronóstico desfavorable. La TCG fue la variable que produjo una disminución más acentuada de la supervivencia de los pacientes estando estrechamente relacionada con la afectación cutánea tumoral y el estadio IIB.
[eng] Background and objective: Cutaneous T-cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS) are rare lymphomas with varying prognoses. The aim of the study was to describe the survival of a cohort of patients with MF/SS and evaluate the prognostic factors impacting disease survival. Materials and methods: All cases of MF/SS diagnosed from 2008 through 2022 were retrospectively analyzed. The demographic variables, histological parameters, and analytical data were analyzed too. Progression-free survival (PFS) and disease-specific survival (DSS) were calculated. Results: A total of 148 cases were included. A total of 121 (82%) and 27 cases were diagnosed with MF, and SS, respectively. A total of 37 patients (25%) experienced progression at some point disease progression. The median PFS and median DSS were 127 and 135 months, respectively. Age >60 years, diagnosis of SS, the presence of large cell transformation (LCT) at diagnosis, folliculotropism in early stages, high Ki-67 expression, the presence of the clonal T-cell receptor (TCR) in blood, elevated LDH and B2M levels, and advanced stages (IIB, IVA, T3, T4, N3/Nx) were associated with worse prognosis across the entire cohort. Conclusions: Stage IVA and the presence of LCT at diagnosis stood out as independent factors of unfavorable prognosis. LCT was the variable that most significantly impacted the patients' survival and was closely associated with tumor skin involvement and stage IIB.
[eng] Background and objective: Cutaneous T-cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS) are rare lymphomas with varying prognoses. The aim of the study was to describe the survival of a cohort of patients with MF/SS and evaluate the prognostic factors impacting disease survival. Materials and methods: All cases of MF/SS diagnosed from 2008 through 2022 were retrospectively analyzed. The demographic variables, histological parameters, and analytical data were analyzed too. Progression-free survival (PFS) and disease-specific survival (DSS) were calculated. Results: A total of 148 cases were included. A total of 121 (82%) and 27 cases were diagnosed with MF, and SS, respectively. A total of 37 patients (25%) experienced progression at some point disease progression. The median PFS and median DSS were 127 and 135 months, respectively. Age >60 years, diagnosis of SS, the presence of large cell transformation (LCT) at diagnosis, folliculotropism in early stages, high Ki-67 expression, the presence of the clonal T-cell receptor (TCR) in blood, elevated LDH and B2M levels, and advanced stages (IIB, IVA, T3, T4, N3/Nx) were associated with worse prognosis across the entire cohort. Conclusions: Stage IVA and the presence of LCT at diagnosis stood out as independent factors of unfavorable prognosis. LCT was the variable that most significantly impacted the patients' survival and was closely associated with tumor skin involvement and stage IIB.
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MORENO VÍLCHEZ, Carlos, SERVITJE BEDATE, Octavio, ÍÑIGUEZ-ARROYO, O., MUNIESA MONTSERRAT, Cristina. Análisis de supervivencia y factores pronósticos en una serie de 148 casos de linfomas cutáneos de células T. _Actas Dermo-Sifiliográficas_. 2023. Vol. 115, núm. 8, pàgs. 766-772. [consulta: 23 de gener de 2026]. ISSN: 0001-7310. [Disponible a: https://hdl.handle.net/2445/221606]