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Low-Grade Cutaneous B-cell Lymphoma in African American Patients

December 2018 | Volume 17 | Issue 12 | Editorials | 1334 | Copyright © December 2018


Shamir Geller MD, Melissa Pulitzer MD, Patricia L. Myskowski MD, Meenal Kheterpal MD

Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY

Statistical analysis was performed using the SPSS software.

RESULTS

Of the 288 patients with CMZL or CFCL, 92.4% (n=266) were white, 3.5% (n=10) were AA (9 non-Hispanic black, 1 unknown ethnicity), 1.7% (n=5) Asian, and 0.7% (n=2) “Other” race. Five patients (1.7%) stated unknown race or didn’t answer. Of the 183 patients with CMZL, 92.9% were white (n=170), 2.7% AA (n=5), and 2.2% Asian (n=4), while of the 105 CFCL patients, 91.4% were white (n=96), 4.8% AA (n=5), and 1.0% Asian (n=1).Comparing the demographic and clinical characteristics of the AA versus the white patients revealed younger age at diagnosis in the former group regardless of the lymphoma subtype (median age, 41 vs 54 years; P equals 0.07). Equal numbers of males and females were found among AA patients compared to a slight male predominance among white patients. 55% of the white patients (146/266) presented with a single lesion (T1), while 70% of AA patients (7/10) presented with regional or generalized disease (T2-3).13 Head and neck involvement was more prevalent in AA compared to white patients (60% vs 31%) with half of the AA patients presenting with lesions localized to the head and neck alone. Disease involvement of three or more body regions (T3b) was found in 20% of the AA patients and in 12% of the white patients. Clinical presentation in AA patients was heterogeneous as described in Table 1 and Figure 1.Initial staging was completed in all cases as per our inclusion criteria. Overall, 7.3% (21/288 patients) were found to have systemic disease with secondary cutaneous involvement, including 19 white patients (12 with CFCL and 7 with CMZL), 1 AA CFCL patient, and one CFCL patient who didn’t provide his race. The rate of concurrent systemic disease diagnosed at initial staging was not significantly different between the ethnic groups (7% in white (19/266) vs 10% in AA patients (1/10)). Five AA patients were lost to follow-up after 1-7 months. In the AA group, 1 patient with PCMZL developed systemic MZL with dural involvement. None of the AA patients with PCFCL developed systemic involvement. According to our institutional records, none of the AA CMZL/CFCL patients died (Table 1). In the white patient’s group, 2 patients with PCMZL and 5 patients with PCFCL were subsequently diagnosed with systemic involvement and 13 patients with CMZL/CFCL died.

DISCUSSION