CD8 mycosis fungoides: A low-grade lymphoproliferative disorder.

Background: The prognosis of the CD8 subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8 MF compared with CD4 MF.

Objectives: To review the cases of CD8 MF in the pediatric and adult populations seen at our institution.

Methods: This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4 from the relevant literature.

Results: Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8 MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004).

Limitations: This is a retrospective review.

Conclusion: Our experience with CD8 MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients.