Racial Disparities in Mycosis Fungoides/Sézary Syndrome-A Single-Center Observational Study of 292 Patients

Racial disparities in incidence, demography and outcomes are seen in mycosis fungoides / Sezary syndrome. We report worse survival in black patients compared to white patients with different survival risk for hypopigmentation, erythroderma and ulceration between the races. The underlying mechanisms require further investigation and may have impact on treatment strategies in these groups. Background: Clinical presentation of Mycosis fungoides/S & eacute;zary syndrome (MF/SS) in Black and Afr ican Amer ican (AA) patients can be heterogeneous with poor survival reported in AA/black patients. In this study, we aim to characterize differences between AA/black and white patients with MF/SS. Patients and Methods: A retrospective single -center hospital -based case -control study including 292 MF/SS patients (146 AA/black matched with 146 white patients). We analyzed demographic, clinical and survival differences. Results: AA/black patients were diagnosed at an earlier age (9 years younger), were predominantly females, had higher rates of Medicaid/Medicare insurance and lower income compared to matched white patients ( P < .001). Adjusting for age, sex, insurance type, and income bracket, AA/black patients had significantly worse overall survival (hazard ratio [HR] 2.88, 95%CI 1.21-6.85, P = .017). Association of clinical MF phenotype with survival showed that hypopigmentation was associated with survival in AA/black patients but not in white patients. Erythroderma and ulceration were associated with worse survival risk in AA/black patients. Conclusions: AA/black patients with MF/SS have a significant worse survival outcome compared to white patients. The association between clinical phenotypes and survival differed between these groups. Further studies are required to investigate whether race -specific pathogenesis or genetic factors may explain these differences.