CD8+ mycosis fungoides: A low-grade lymphoproliferative disorder

J Am Acad Dermatol. 2017 Sep;77(3):489-496. doi: 10.1016/j.jaad.2017.05.015. Epub 2017 Jul 1.

Abstract

Background: The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8+ MF compared with CD4+ MF.

Objectives: To review the cases of CD8+ MF in the pediatric and adult populations seen at our institution.

Methods: This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4+ from the relevant literature.

Results: Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8+ MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004).

Limitations: This is a retrospective review.

Conclusion: Our experience with CD8+ MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.

Keywords: CD8(+) phenotype; cutaneous lymphoma; lymphoproliferative disorder; mycosis fungoides; prognosis; skin directed-therapies.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • CD8 Antigens / biosynthesis
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides / metabolism
  • Mycosis Fungoides / pathology*
  • Neoplasm Grading
  • Prognosis
  • Retrospective Studies
  • Skin Neoplasms / metabolism
  • Skin Neoplasms / pathology*
  • Young Adult

Substances

  • CD8 Antigens