Clinical Characteristics, Management and Long‐Term Outcomes of 180 Patients With Early‐Stage Mycosis Fungoides at a Tertiary Centre—A 34‐Year Retrospective Study

ABSTRACT Background Mycosis fungoides (MF) is the commonest form of primary cutaneous T‐cell lymphoma. Progression is slow, with frequent relapses. Data for predicting early‐stage MF progression and recurrence are inadequate. Methods The clinical profile, treatment response, relapse, progression to advanced stage and final status of 180 patients diagnosed with early MF between January 1987 and September 2021 were investigated retrospectively. Results Ninety‐four (52.2%) patients were female and 86 (47.8%) male. Stage at diagnosis was IA in 74 (41.1%) patients, IB in 72 (40%) and IIA in 34 (18.9%). Initial treatment was PUVA in 76 (42.2%) patients and NB–UVB in 59 (32.7%). Complete response occurred in 109 (60.5%) patients, and 73 (51.5%) patients experienced recurrence. Stage IA/IB at diagnosis, normal B‐2‐microglobulin levels and low CLIPI score were associated with complete response. Progression to advanced stage occurred in 27 (%15) patients. Age 60 and over at diagnosis, stage at diagnosis, pruritus, LDH, CLIPI score between 3 and 5, and folliculotropism in pathology were found to be negative prognostic factors in progression to advanced stage. Classical pathology, PUVA treatment and complete response to initial treatment were found to be positive prognostic factors. In multivariate analysis, LDH and complete responsiveness to initial treatment were independently associated with progression to advanced stage. Conclusion Advanced age at diagnosis, a high CLIPI score and folliculotropism affect both progression to advanced stage and the final status of the disease. LDH level is a crucial indicator of progression to an advanced stage. Early diagnosis affects the treatment response, with a complete response to the initial treatment mitigating the risk of advanced‐stage progression.