Ki67 and CD30 Predict Survival in Non-Transformed Mycosis Fungoides
JT Edinger, BZ Clark, BE Pucevich, LJ Geskin, SH Swerdlow. U. of Pittsburgh Sch. of Med., Pittsburgh, PA
Background: Mycosis fungoides (MF) has a usually indolent but sometimes aggressive course. CD30 is usually assumed to be associated with transformation and its extent and significance in non-transformed MF is uncertain. The prognostic impact of Ki67 staining is also uncertain.
Design: After a small pilot study, 47 biopsies of non-transformed MF (36 first diagnostic bx, 11 first bx at UPMC) were stained for Ki67 and CD30. Up to 1000 dermal (D) and epidermal (Ep) lymphocytes were separately counted and % Ki67+ and CD30+ cells calculated. Results were correlated with stage at dx (44 patients), therapy types and survival from onset of rash, definitive dx, and bx date.
Results: All cases had at least rare D-CD30+ cells. Higher %'s of D-CD30+ and D-Ki67+ lymphoid cells were associated with a significantly higher stage at dx. CD30 positivity did not correlate with the proportion of Ki67+ cells. There were no correlations with patients' therapies.
Ki67 & CD30 vs stage at Dx
|Ki67+, meanSD,%||CD30+, meanSD,%|
|Stage at Dx||ns||p<0.05||ns||p=0.040|
Survivals from time of dx, time of bx, and onset of rash were all significantly worse if Ep or D-Ki67 or D-CD30 was greater than the median (14%, 13%, 4.7%). D-Ki67 as a continuous variable was an independent prognostic indicator (p<.001), as were D-Ki67 (p=.004) and D-CD30 (p=.027) but not stage analyzed as dichotomous variables.
Conclusions: CD30+ cells are present in non-transformed MF often with <10% in the dermis and usually greater proportions in the epidermis. D-CD30% greater than the median and, to a greater extent, D-Ki67% are independent adverse prognostic indicators.
Monday, March 9, 2009 9:30 AM
Poster Session I Stowell-Orbison/Autopsy Award # 180, Monday Morning