Mycosis Fungoides (MF) is a skin disorder that causes rashes, itching, and lesions. It progresses from the skin internally, causing tumors and T-cell lymphoma. The treatments include topical drugs (steroids, retinoid), chemotherapy, and phototherapy. Both skin directed therapies (SDT) and systemic therapy (ST) are helpful based on the severity. This PROCLIP study examines front-line treatments and MF patients’ quality of life.

The objective of the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIP) is to analyze systemic parameters, Quality of Life measures, response rates, and tumor-node-metastasis-blood (TNMB) staging system differences. The study involved 17 countries, 41 centers, and 395 early-stage MF patients. The central clinicopathological review, uni, and multivariate analysis were the tools used on this international database.

The SDT therapy involved 81.6% of patients, while 44 cases or 11.1% had systemic therapy. The expectant observation was 7.3%. Univariate analysis associated the ST usage with higher clinical stage, plaque presence, higher mSWAT, and folliculotropic MF (FMF). Multivariate analyses highlighted associations with plaque presence and FMF. The overall response rate to first-line SDT and ST were 73% and 57%, respectively. The QOL also improved in both groups in terms of disease stability and responsiveness.

Treatment choices get influenced by plaque presence and FMF. SDT was superior to ST, but future therapy guidelines should address such issues.

Ref: https://onlinelibrary.wiley.com/doi/10.1111/bjd.19252