A large multicentre cohort study confirms that hypopigmented mycosis fungoides in adults typically follows an indolent clinical course. Researchers analyzed 224 patients across six US tertiary referral centers between 2011 and 2023. The median age at diagnosis was 44, with the cohort predominantly comprising Black females. Nearly all participants presented with early-stage disease.
Clinical outcomes remained favorable regardless of immunophenotype or variant presentation. Ninety percent of treated patients received skin-directed therapies alone. Among those with available response data, 77% achieved complete or partial remission. Only 6% experienced progressive disease during a median follow-up of 39 months.
Progression from early-stage to advanced-stage disease proved exceptionally rare, affecting just 2% of the cohort. While peripheral blood T-cell receptor monoclonality correlated with poorer treatment response, it did not predict disease advancement. Investigators concluded this rare subtype carries a benign prognosis with no independent baseline factors linked to progression.