Mycosis Fungoides in Solid-Organ Transplant Recipients: A Multicenter Retrospective Cohort Study

Area of Science:

• Dermatology
• Oncology
• Transplantation Medicine

Background:

• Mycosis fungoides (MF) is a rare cutaneous T-cell lymphoma.
• MF in solid-organ transplant recipients (SOTRs) is exceptionally uncommon, with limited published data on its characteristics.
• Understanding MF in SOTRs is crucial for managing these complex cases.

Purpose of the Study:

• To investigate the clinical characteristics of MF in SOTRs.
• To analyze the impact of immunosuppressive therapy on MF development and progression in transplant recipients.
• To provide insights into the disease course and management strategies for MF in this specific patient population.

Main Methods:

• Retrospective cohort study of SOTRs diagnosed with MF.
• Data collected from January 2010 to February 2022 across three cutaneous lymphoma clinics.
• Analysis included patient demographics, transplant details, immunosuppressive regimens, MF stage, treatment, and outcomes.

Main Results:

• Ten SOTRs with MF were identified (median age at transplant 33, at MF diagnosis 48 years).
• Median time from transplant to MF diagnosis was 8 years; 40% diagnosed before 18 years.
• Most patients had early-stage (IA/IB) or folliculotropic MF, responding to skin-directed therapies; no significant stage progression observed during follow-up.

Conclusions:

• MF in SOTRs is often diagnosed at an early stage and shows a predilection for folliculotropic variants and pediatric onset.
• Modification of immunosuppressive therapy was infrequent and requires careful consideration of organ rejection risks.
• The disease course in SOTRs, within the limited follow-up period, resembled that in immunocompetent individuals.