Background

Cutaneous T-cell lymphoma (CTCL) patients report high distress related to the disease. Despite the known affection of the patient well-being, few studies have explored the impact of CTCL on health-related quality of life (HRQoL) and compared the affectation with other patients with cancer.

Methods

A cross-sectional observational study was designed to analyze HRQoL of CTCL patients. A total of 23 Spanish dermatologist and hematologist form 15 public hospitals completed the study. Adult patients with Mycosis Fungoides (MF) and Sézary Syndrome (SS) were selected with stablished diagnosis at least one year before the study. EORTC-QLQ-C30 v3 and SKINDEX-29 HRQoL questionnaires were completed. A ten-point numeric scale was used to evaluate the pruritus intensity. Current and diagnosis staging, mSWAT tumor extension index, ECOG, and LDH were recorded.

Results

A total of 141 patients were included, 81 male (57.4%), with a mean age of 63.6 years old (95%CI 61.4-65.7). MF was diagnosed in 109 patients (77.3%) and SS in 32 patients (22.7%). The mean age at diagnosis was 56.2 years old (CI95% 53.9-58.6), and the disease duration at selection was 6.7 years (CI95% 5.8-7.6). ECOG-0 was the functional status of 99 patients (70.2%), ECOG-1 in 29 patients (20.6%), ECOG-2 in 12 patients (8.5%). Mean mSWAT was 38.4 (95%CI 30.2-46.5). The patient's distribution by stage was: I- 34.8%, II-26.2%, III- 12.1% and IV-27%. The mean pruritus intensity 3.6 (95%CI 3.1-4.2). The EORTC-QLQ-C30 global health status/QoL, functional and symptom scales were compared to reference values of patients with cancer and healthy population (figure 1). Global health status showed worse scores in CTCL patients compared to healthy population (p<0,05), but did not differ from other patients with cancer. The physical functioning and rol functioning in CTCL were better than other patients with cancer (p<0,05) but worse than healthy population (p<0,05). The emotional and cognitive functioning did not differ between other patients with cancer or healthy population. The social functioning resulted like other patients with cancer but worse than healthy (p<0,05). In the multivariate analysis of the Global health status, better scores were observed with aging (p=0.023) and worse scores in patients with ECOG-1 vs ECOG-0 (p=0.01). The SKINDEX-29 global score was 28.5 (95%CI 24.8-32.3).

Conclusions

With the results of the study, we were able to place the CTCL patients in the map of HRQoL affectation compared to other patients with cancer. We found that Global health status in MF/SS was like other patients with cancer, and worse than age-matched healthy population. This result is relevant as HRQoL reflects how the patients are coping with their disease, is a prognostic factor for clinical outcomes, could predict survival and response to treatment and is related to the economic burden of the disease.