Clinical characteristics and survival outcomes of primary cutaneous T-cell lymphoma in disaggregated Asian American, Native Hawaiian, and Pacific Islander populations

Summary: Abstract Body: Current research on cutaneous T-cell lymphoma (CTCL) commonly aggregates Asian American (AA) and Native Hawaiian and Other Pacific Islander (NHOPI) patients into a single racial category. This restrospective cohort study uses SEER data to explore differences in clinical presentation and disease-specific survival among disaggregated AA and NHOPI populations. We analyzed 168 Chinese, 169 Filipino, 48 Vietnamese, 79 Japanese, 149 Asian Indian or Pakistani (AIP), 39 Korean, 63 NHOPI, and 207 Other Asian patients diagnosed with histologically confirmed primary CTCL, alongside 8,289 non-Hispanic White (NHW) patients for comparison. When disaggregated, AIP patients were more likely to be diagnosed at a younger age (42 years), while Japanese patients were more likely to be diagnosed at an older age (65 years). Rates of distant disease at diagnosis varied significantly among these groups, with Korean patients having the highest rates (18%) and AIP patients having the lowest (5.4%). Regarding survival, Korean patients experienced poorer overall survival (aHR=2.69, 95% CI=1.58–4.57) and higher disease-specific mortality than NHW patients (aHR=2.44, 95% CI=1.32–4.52), whereas Japanese patients exhibited lower disease-specific mortality (aHR=0.45, 95% CI=0.22–0.93). Disaggregating AA and NHOPI populations in CTCL reveals important disparities that are otherwise masked in aggregated analyses. These findings highlight the heterogeneity among AA and NHOPI populations—shaped by differences in genetics, cultural practices, and healthcare use—and emphasize the need for targeted awareness and education efforts, particularly for Korean patients. As AA and NHOPI populations continue to grow in the US, further research is essential to develop interventions that address disparities in CTCL presentation and outcomes. Daniel Y. Kim^{2, 1, 3}, Timothy M. Dang⁴, Neda Shahriari^{2, 1, 3}, Sasha Stephen^{2, 1, 3}, Nicole R. LeBoeuf^{2, 1, 3}, Cecilia Larocca^{2, 1, 3} 1. Dermatology, Brigham and Women's Hospital, Boston, MA, United States. 2. Harvard Medical School, Boston, MA, United States. 3. Dermatology, Dana-Farber Cancer Institute, Boston, MA, United States. 4. Dermatology, University of California San Diego, La Jolla, CA, United States. Clinical Research: Epidemiology and Observational Research