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Assaf C, Dobos G, Zech IM, Doess A, May M, Jadasz J. Epidemiologie reifzelliger T- und NK-Zell-Lymphome in Deutschland - Eine repräsentative Querschnittanalyse von GKV-Routinedaten: Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data. J Dtsch Dermatol Ges 2023; 21:1320-1328. [PMID: 37946651 DOI: 10.1111/ddg.15187_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/18/2023] [Indexed: 11/12/2023]
Abstract
ZusammenfassungHintergrundPrimäre kutane Lymphome sind seltene lymphoproliferative Neoplasien und gehören zur heterogenen Gruppe der Non‐Hodgkin‐Lymphome. Sie umfassen ein klinisch und histologisch breites Spektrum an Manifestationsformen, wobei kutane T‐Zell‐Lymphome (CTCL) mit 73% am häufigsten sind. Aufgrund der Seltenheit der Erkrankungen sind bevölkerungsbasierte Untersuchungen zur Versorgungssituation und Epidemiologie kaum vorhanden.Patienten und MethodikAuf Basis anonymisierter, alters‐ und geschlechtsadjustierter GKV‐Routinedaten von circa fünf Millionen gesetzlich Krankenversicherten wurde im Sechsjahreszeitraum (2012–2017) eine retrospektive Analyse zur Bestimmung von Prävalenz, Inzidenz und Letalität von Patienten mit reifzelligen T/NK‐Zell Lymphomen in Deutschland durchgeführt.ErgebnisseInsgesamt 1336 T‐Zell‐Lymphom‐Patienten konnten im Beobachtungszeitraum identifiziert werden. Die Sechsjahres‐Prävalenz liegt demnach zwischen 27,35 und 43,58 pro 100 000 Einwohner. Die Patienten waren zu 65% männlich mit einem durchschnittlichen Alter von 66 Jahren (SD 15). Es verstarben 246 Patienten (circa 20 %) innerhalb der 6 Jahre, pro Jahr bis zu 7 %. Die ermittelte Inzidenz bei 153 identifizierten Patienten im Jahr 2017 liegt bei 3,65 bis 3,92 pro 100 000 Einwohner.SchlussfolgerungenErstmalig in Deutschland wurden mithilfe von Abrechnungsdaten der gesetzlichen Krankenversicherung (GKV‐Routinedaten), valide epidemiologische Erkenntnisse von Patienten mit reifzelligen T‐ und NK‐Zell Lymphomen gewonnen. Weitere Analysen für tiefergehende Einblicke in die Versorgung der Patienten mit dieser seltenen Erkrankung sind wünschenswert.
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Affiliation(s)
- Chalid Assaf
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Krefeld, Krefeld
- Institute for Molecular Medicine, Medical School Hamburg, Hamburg
- Klinik für Dermatologie, HELIOS Klinikum Schwerin, universitärer Campus der Medical School Hamburg, Schwerin
| | - Gabor Dobos
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, gemeinsame Medizinische Fakultät Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
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Assaf C, Dobos G, Zech IM, Doess A, May M, Jadasz J. Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data. J Dtsch Dermatol Ges 2023; 21:1320-1327. [PMID: 37845021 DOI: 10.1111/ddg.15187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/18/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Primary cutaneous lymphomas (PCL) are rare skin tumors of lymphoproliferative neoplasms and belong to the heterogeneous group of non-Hodgkin's lymphomas. PCL encompass a broad spectrum of clinical and histologic manifestations, with cutaneous T-cell lymphoma (CTCL) being the most common (73%). Due to the rarity of the diseases, population-based studies of care and epidemiology are limited. PATIENTS AND METHODS Based on anonymized, age- and sex-adjusted SHI (statutory health insurance) claims data of approximately five million SHI-insured patients, a retrospective analysis was conducted over a six-year period (2012-2017) to determine the prevalence, incidence, and lethality in patients with mature-cell T/NK-cell lymphoma in Germany. RESULTS A total of 1,336 patients with T-cell lymphoma were identified during the observation period. The six-year prevalence ranged from 27.35 to 43.58 per 100,000. Patients were 65% male with a mean age of 66 years (SD 15). There were 246 patients (approx. 20%) who died within the 6 years, up to 7% per year. The calculated incidence in 153 identified patients in 2017 is 3.65 to 3.92 per 100,000. CONCLUSIONS For the first time, valid epidemiologic findings of patients with mature T-cell and NK-cell lymphomas were obtained using SHI claims data in Germany. Further analyses are needed to gain a deeper insight into the healthcare reality of patients with this rare disease.
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Affiliation(s)
- Chalid Assaf
- Department of Dermatology and Venerology, HELIOS Klinikum Krefeld, Krefeld, Germany
- Institute for Molecular Medicine, Hamburg Medical School, Hamburg, Germany
- Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of the Hamburg Medical School, Schwerin, Germany
| | - Gabor Dobos
- Clinic for Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Joint Faculty of Medicine of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany
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Gosmann J, Bielefeld A, Schmitz FJ, Schaper-Gerhardt K, Gutzmer R, Stadler R. Die Wirkung von Mogamulizumab auf die aberrante T-Zell-Population im peripheren Blut - eine monozentrische retrospektive Analyse. J Dtsch Dermatol Ges 2023; 21:992-1002. [PMID: 37700404 DOI: 10.1111/ddg.15144_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/07/2023] [Indexed: 09/14/2023]
Abstract
ZusammenfassungHintergrundDie Wirkung von Mogamulizumab bei kutanen T‐Zell‐Lymphomen (CTCL) auf die T‐Zellen (TZ) im peripheren Blut und deren potenzielle Rolle bei der Steuerung von Behandlungsintervallen wird noch erforscht.MethodikWir untersuchten in einer retrospektiven monozentrischen Analyse die Wirkung von Mogamulizumab auf die CD3+ TZ und die aberrante T‐Zellpopulation (TZP), CD4+/CD7– und die CD4+/CD26– TZ, die mittels Durchflusszytometrie analysiert wurden.ErgebnisseDreizehn Patienten mit CTCL wurden eingeschlossen. Nach vier Zyklen kam es zu einer durchschnittlichen Reduktion der CD3+ TZ um 57%, der CD4+/CD7− um 72% und der CD4+/CD26− TZ um 75% im Vergleich zum individuellen Ausgangswert eines jeden Patienten. Die Reduktionen der CD4+/CD7+ und CD4+/CD26+ TZ fielen mit durchschnittlich 54% und 41% geringer aus. Ein signifikanter Rückgang der aberranten TZP war bereits nach der ersten Infusion zu beobachten. Ein medianes Plateau der TZP trat bereits während der Induktionsphase ein. Bei 5/13 Patienten kam es zu einem Progress der Erkrankung, ohne dass eine eindeutige Korrelation mit der aberranten TZP bestand.SchlussfolgerungenBereits nach einer Gabe Mogamulizumab reduzierte sich die aberrante TZP und – in geringerem Maße – die normale TZP. Wir konnten keine eindeutige Korrelation der TZP mit der Wirksamkeit von Mogamulizumab beobachten. Es werden weitere Untersuchungen mit einer größeren Anzahl von Patienten benötigt.
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Affiliation(s)
- Janika Gosmann
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Hauttumorzentrum, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
| | - Annette Bielefeld
- Institut für Laboratoriumsmedizin, Mikrobiologie, Umweltmedizin und Transfusionsmedizin, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
| | - Franz-Josef Schmitz
- Institut für Laboratoriumsmedizin, Mikrobiologie, Umweltmedizin und Transfusionsmedizin, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
| | - Katrin Schaper-Gerhardt
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Hauttumorzentrum, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
- Klinik für Dermatologie, Allergologie und Venerologie, Hauttumorzentrum Hannover (HTZH), Medizinische Hochschule Hannover
| | - Ralf Gutzmer
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Hauttumorzentrum, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
| | - Rudolf Stadler
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Hauttumorzentrum, Johannes Wesling Klinikum Minden, Ruhr-Universität Bochum, Minden
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Gosmann J, Bielefeld A, Schmitz FJ, Schaper-Gerhardt K, Gutzmer R, Stadler R. The effect of mogamulizumab on the aberrant T cell population in the peripheral blood - A monocentric retrospective analysis. J Dtsch Dermatol Ges 2023; 21:992-1002. [PMID: 37401138 DOI: 10.1111/ddg.15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/07/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND AND OBJECTIVES The effect of mogamulizumab in cutaneous T-cell lymphoma (CTCL) on T cells (TC) in the peripheral blood and its potential role to navigate treatment intervals are explored. METHODS We investigated within a retrospective monocentric analysis the effect of mogamulizumab on the CD3+ TC and the aberrant T cell population (TCP), i.e., the CD4+ /CD7- and the CD4+ /CD26- TC, analyzed by flow cytometry. RESULTS Thirteen patients with CTCL were included. After four cycles there was a mean reduction of 57% in CD3+ TC, 72% in the CD4+ /CD7- and 75% in the CD4+ /CD26- TCP compared to the individual baseline of each patient. The reduction in CD4+ /CD7+ and CD4+ /CD26+ TC was lower, averaging 54% and 41%. A significant decrease in aberrant TCP was already evident after the first administration. A median plateau of TCP already occurred during the IP. Progressive disease occurred in 5/13 patients without a clear correlation to aberrant TCP. CONCLUSIONS Already after one dose of mogamulizumab, aberrant TCP and, to a lesser extent, normal TC decrease. We did not observe a clear correlation between TCP and the efficacy of mogamulizumab, but further studies with larger numbers of patients are needed.
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Affiliation(s)
- Janika Gosmann
- University Department for Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
| | - Annette Bielefeld
- Institute for laboratory medicine, microbiology, environmental medicine and transfusion medicine, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
| | - Franz-Josef Schmitz
- Institute for laboratory medicine, microbiology, environmental medicine and transfusion medicine, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
| | - Katrin Schaper-Gerhardt
- University Department for Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
- Department of Dermatology, Allergology and Venereology, Hannover Skin Cancer Center (HTZH), Hannover Medical School, Hannover, Germany
| | - Ralf Gutzmer
- University Department for Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
| | - Rudolf Stadler
- University Department for Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany
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Wojewoda K, Gillstedt M, Englund H, Ali S, Lewerin C, Osmancevic A. Diagnostic Outcomes and Treatment Modalities in Patients with Mycosis Fungoides in West Sweden—A Retrospective Register-Based Study. Cancers (Basel) 2022; 14:cancers14194661. [PMID: 36230583 PMCID: PMC9563600 DOI: 10.3390/cancers14194661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Mycosis fungoides (MF) is a rare and incurable disease, but there are a wide variety of treatment options. Since the condition is rare, only a few studies have been performed on this topic in Sweden. This study contributes to the knowledge of the epidemiological and clinical features and diagnostic findings in addition to the treatment modalities and responses in patients with diagnosed MF and/or followed up for a long period of time in Sweden. The results of this study can be used to improve clinical practice and stimulate future research. Abstract (1) Background: Mycosis fungoides (MF) is a variant of primary cutaneous T-cell lymphoma. The aim of this study was to describe the clinical features and epidemiological and diagnostic findings in addition to the treatment modalities and responses in patients with MF. Furthermore, comparisons between patients in the early stage and the advanced stage were evaluated. (2) Methods: A retrospective register-based study based on data collected from the primary cutaneous lymphoma register and medical records was performed at the Department of Dermatology and Venerology at Sahlgrenska University Hospital, Gothenburg, Sweden. (3) Results: Eighty-four patients with a median age of 55 years with MF were included. Most of the patients (n = 73) were diagnosed at the early stage of the disease (IA–IIA). Overall disease progression was seen in 12.5% (n = 9) of the patients. Nine (10.7%) patients were deceased, out of which four (4.8%) deaths were associated with MF-related causes. (4) Conclusions: This study contributes to the knowledge of the epidemiological and clinical features in addition to the diagnostic findings and treatment responses in patients with MF in Sweden.
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Affiliation(s)
- Karolina Wojewoda
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 46 Gothenburg, Sweden
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 46 Gothenburg, Sweden
- Correspondence:
| | - Martin Gillstedt
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 46 Gothenburg, Sweden
| | - Hanna Englund
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 46 Gothenburg, Sweden
| | - Shada Ali
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 46 Gothenburg, Sweden
| | - Catharina Lewerin
- Section of Hematology and Coagulation, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 46 Gothenburg, Sweden
| | - Amra Osmancevic
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 46 Gothenburg, Sweden
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, 413 46 Gothenburg, Sweden
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