Racial differences in mycosis fungoides and Sézary syndrome: A multicenter cohort study

Background The association between race on outcomes in mycosis fungoides and Sézary syndrome (MF/SS) is poorly understood. Objective To evaluate the association between clinical characteristics, including self-identified race, on patient outcomes in a multicenter cohort study of patients with MF/SS. Methods A retrospective cohort analysis was conducted at 7 academic institutions with high representation of Black patients with MF/SS. Patients diagnosed between 2010 and 2021 with consistent follow-up, confirmed diagnosis of MF/SS, and pathology reports available were eligible. Self-reported racial groups were obtained from medical records. Univariate and multivariable models and Kaplan-Meier assessments were analyzed for overall survival. The primary outcome was to assess differences in overall survival among Black patients. The hypotheses were formulated prior to data collection. Results 883 patients with MF/SS were identified, including 419 (47.4%) Black and 464 (56.6%) White patients. Compared to White MF/SS patients, Black patients presented younger with higher stage at diagnosis and worse survival in the cohort aged more than 60 years. Limitations Referral bias due to the setting at tertiary care academic centers and lack of central pathologic review limits interpretation of this study. Conclusions Compared with White patients, Black patients with MF/SS have higher-risk clinical features and decreased survival in the older patients.