A Multicenter Retrospective Study of Narrowband UVB Response Across Skin Types in Mycosis Fungoides
Notice bibliographique
Résumé
Background: Mycosis fungoides (MF) is the most common variant of cutaneous T-cell lymphoma, a heterogeneous group of non-Hodgkin lymphomas that primarily affect the skin. Narrowband UVB (NB-UVB) phototherapy is a first-line treatment for early-stage MF across Fitzpatrick skin types (FSTs). However, existing NB-UVB guidelines are largely derived from studies with limited skin type diversity. In a 2023 pilot study, our group demonstrated that MF patients with higher FSTs experience slower improvement on NB-UVB. Here, we validate and expand these findings using a multicenter cohort. Methods: We conducted a retrospective chart review of MF patients at Columbia, Johns Hopkins, and Emory Universities who underwent NB-UVB monotherapy between January 2010 and June 2025. Patients were included if they had demonstrable disease within 90 days of NB-UVB initiation and at least two documented disease severity assessments (measured as % total body surface area [TBSA] involved). Patients receiving concurrent systemic therapy and radiation were excluded. Patients were stratified by FST (I-III vs IV-VI). Timepoints were categorized as baseline, mid-year, year-end, and end of follow-up. The primary outcome was the change in TBSA involvement at each timepoint. Statistical analyses included Chi-square and Fisher’s exact tests for categorical variables, and Wilcoxon rank-sum and Welch t tests for continuous variables; α = 0.05. Results: A total of 114 patients (63 FST I-III, 51 FST IV-VI) met inclusion criteria. Baseline demographic and disease characteristics differed between groups: patients with FST IV-VI were younger (mean age 49 vs 60 years, p < 0.001) and more likely to present with hypopigmented MF (43% vs 4.8%, p < 0.001). Patients with FST I-III experienced significantly greater percent reductions in TBSA than those with FST IV-VI, with reductions of 73% versus 35% at mid-year (p = 0.009), 78% versus 26% at year-end (p = 0.009), and 78% versus 47% at end of follow-up (p = 0.006). Absolute TBSA reductions mirrored these trends, with greater improvement observed in FST I-III at year-end (−14 vs −10, p = 0.037). Conclusion: Across three academic centers, patients with FST I-III demonstrated significantly greater clinical improvement on NB-UVB than patients with FST IV-VI at mid-year, year-end, and end of follow-up. Potential contributors include disease presentation differences, variability in dosing regimens, and post-inflammatory hyperpigmentation mimicking persistent disease in patients with skin of color, leading to perception of lesser improvement. Larger retrospective and prospective studies are needed to elucidate these disparities and inform treatment strategies to promote equitable outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,006 | 0,015 |
| Études des sciences et des technologies | 0,001 | 0,007 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».