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A new prognostic index (CLIPI) for advanced cutaneous lymphoma enables precise patient risk stratification

Scarisbrick, J. J.
; 
Quaglino, P.
; 
Whittaker, S.
; 
Bagot, M.
; 
Guenova, E.
; 
Papadavid, E.
; 
Prince, H. M.
; 
Sanches, J. A.
; 
Miyashiro, D. R.
; 
Servitje, O.
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Abstract
Advanced mycosis fungoides (MF) and Sézary syndrome (SS) have a poor overall survival (OS) of <5 years. Studies have found the current staging (IA-IVB) is inadequate for risk stratification. The PROCLIPI (Prospective Cutaneous Lymphoma International Prognostic Index) study was launched in 2015 at 46 international expert MF/SS centers, prospectively collecting predefined data sets in patients with newly diagnosed MF/SS, to determine a cutaneous lymphoma IPI (CLIPI). Five hundred fifty-two patients with advanced stage MF/SS were recruited. The 5-year OS was 50.0% for stage IIB, 64.8% for stage IIIA, 43.9% for stage IIIB, 50.8% for stage IVA1, 25.9% for stage IVA2, and 36.9% for stage IVB. Factors at diagnosis associated with a significantly worse survival were N3 status (P < .001), age >60 years (P < .001), raised serum lactate dehydrogenase (P = .005), and large-cell transformation in skin (P = .006). Modeling these 4 independent risk factors into a CLIPI found that there was a worse OS in high- vs low-risk (P < .001), high- vs intermediate-risk (P = .002) and intermediate- vs low-risk (P = .010) groups. Five-year OS was 63.3%, 44.7%, and 18.3% in the low-, intermediate-, and high-risk groups, respectively. In this advanced stage cohort there was a low 5-year survival and increasing stage was not associated with worsening survival. The use of CLIPI to stratify patients into risk groups has the potential to improve outcomes and aid optimal treatment selection. This trial was registered at www.ClinicalTrials.gov as #NCT02848274.
Authors
Scarisbrick, J. J.
Quaglino, P.
Whittaker, S.
Bagot, M.
Guenova, E.
Papadavid, E.
Prince, H. M.
Sanches, J. A.
Miyashiro, D. R.
Servitje, O.
Querfeld, C.
Akilov, O.
Arumainathan, A.
Bennett, L.
Battistella, M.
Benstead, K.
Berti, E.
Beylot-Barry, M.
Busschots, A. M.
Cowan, R.
Dummer, R.
Dunnill, G.
Estrach, T.
Evison, F.
Bashir, A.
Geskin, L.
Gru, A.
Guitart, J.
Herrera, M. C.
Hodak, E.
Horwitz, S.
Jonak, C.
Klemke, C. D.
Knobler, R.
McKay, P.
Marschalkó, M.
Massone, C.
Matin, R.
Mitteldorf, C.
Novoa, R.
Ortiz-Romero, P.
Pimpinelli, N.
Pujol, R. M.
Ranki, A.
Vakeva, L.
Rieger, K. E.
Stadler, R.
Trautinger, F.
Latzka, J.
Vermeer, M.
Wachsmuth, R.
Weatherhead, S.
Wehkamp, U.
Wobser, M.
Kim, Y. H.
Affiliation
Department of Dermatology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust and University of Birmingham, Birmingham, United Kingdom. Clinic of Dermatology, Department of Medical Sciences, University of Turin Medical School, Turin, Italy. St Johns Institute of Dermatology, King's College London, London, United Kingdom. Hôpital Saint Louis, Université Paris Cité, Paris, France. Department of Dermatology, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland. Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Athens, Greece. Epworth Healthcare, Peter McCallum Cancer Center, The University of Melbourne, Monash University, Melbourne, Australia. Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil. Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain. City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA. UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA. Royal Liverpool University Hospital, The Clatterbridge Cancer Centre, Liverpool, United Kingdom. University Hospital Southampton, Southampton, United Kingdom. Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom. Department of Dermatology, University of Milan, Milan, Italy. Department of Dermatology, University and Hospital of Bordeaux, Bordeaux, France. Department of Dermatology, University Hospitals Leuven, Leuven, Belgium. The Christie Hospital, Manchester, United Kingdom. Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland. Bristol Royal Infirmary, Bristol, United Kingdom. Hospital Clinic, University of Barcelona, Barcelona, Spain. Columbia University Medical Center, New York, NY. Departments of Dermatology and Pathology, Northwestern University, Chicago, IL. Department of Dermatology, Stanford University School of Medicine, Palo Alto, CA. Cutaneous Lymphoma Unit, Davidoff Cancer Center, Beilinson Hospital, Tel Aviv University, Tel Aviv Rabin Medical Center, Tel Aviv, Israel. Memorial Sloan Kettering Cancer Center, New York, NY. University of Vienna Medical School, Vienna, Austria. Department of Dermatology, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Germany. Beatson West of Scotland Cancer Center, Glasgow, United Kingdom. Department of Dermato-venereology, Semmelweis Medical University, Budapest, Hungary. Dermatology Unit, Galliera Hospital, Genoa, Italy. Oxford University Hospitals NHS Trust, Oxford, United Kingdom. Dermatopathology and Cutaneous Lymphoma Unit, Department of Dermatology, Venereology und Allergology, HELIOS Klinikum Hildesheim GmbH, Hildesheim, Germany. Department of Pathology, Stanford University School of Medicine, Palo Alto, CA. Dermatology Department, Institute i+12, Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain. Department of Dermatological Sciences, University of Florence, Florence, Italy. Dermatology Department, Hospital del Mar, Barcelona, Spain. Department of Skin and Allergic Diseases, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. Cutaneous Lymphoma Centre, Department of Dermatology, Johannes Wesling Medical Centre, University Hospitals of the Ruhr University of Bochum, Minden, Germany. Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St Pölten, Austria. Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands. Royal Devon and Exeter Hospital, Taunton and Somerset NHS Foundation Trust, Exeter, United Kingdom. Newcastle Upon Tyne NHS Trust, Newcastle, United Kingdom. Department of Dermatology Medical Department II, Christian-Albrechts-University Kiel, University Hospital of Munich, Munich, Germany. Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany. University Institute and Clinic for Immunodermatology, Medical Faculty, Johannes Kepler University, Linz, Austria.
Description
Date
2025
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All Christie Publications
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Article
Citation
Scarisbrick JJ, Quaglino P, Whittaker S, Bagot M, Guenova E, Papadavid E, et al. A new prognostic index (CLIPI) for advanced cutaneous lymphoma enables precise patient risk stratification. Blood. 2025 Oct 2;146(14):1687-92. PubMed PMID: 40663780. Epub 2025/07/15. eng.
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https://christie.openrepository.com/handle/10541/627443
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