Monitoring the decrease of circulating malignant T cells in cutaneous T-cell lymphoma during photopheresis and interferon therapy
- PMID: 12873887
- DOI: 10.1001/archderm.139.7.909
Monitoring the decrease of circulating malignant T cells in cutaneous T-cell lymphoma during photopheresis and interferon therapy
Abstract
Background: The prognosis of patients with stage IV cutaneous T-cell lymphoma (CTCL) is grim and therapeutic options are limited. Treatment of advanced-stage CTCL is aimed at suppressing the dominant T-cell clone, which is typically present in the skin, peripheral blood, and lymph nodes.
Observations: We detected the expansion of 1 T-cell clone expressing the T-cell receptor V beta 14 in the peripheral blood of a patient with stage IVA CTCL. Before initiation of combination therapy with photopheresis and low-dose interferon alpha, the dominant T-cell clone represented 84% of the total T-cell population. After successful therapy, this clone showed a dramatic decrease to 6% of the T-cell population after 6 months of treatment. This reduction in the percentage of the malignant T-cell population in response to therapy was paralleled by clinical skin improvement from initial generalized erythroderma to undetectable skin disease.
Conclusions: This case demonstrates that response to combination treatment with photopheresis and low-dose interferon alpha in patients with advanced CTCL may be accurately and quantitatively followed up by monitoring the percentage of the malignant T-cell clone (when identifiable) within the total circulating T-cell population by flow cytometry.
Similar articles
-
Cutaneous T cell lymphoma: the helping hand of dendritic cells.Ann N Y Acad Sci. 2001 Sep;941:1-11. Ann N Y Acad Sci. 2001. PMID: 11594563 Review.
-
Durable loss of a malignant T-cell clone in a stage IV cutaneous T-cell lymphoma patient treated with high-dose interferon and photopheresis.J Am Acad Dermatol. 1999 Nov;41(5 Pt 2):880-3. doi: 10.1016/s0190-9622(99)70351-8. J Am Acad Dermatol. 1999. PMID: 10534677
-
Analysis of T-cell receptor gene rearrangement for predicting clinical outcome in patients with cutaneous T-cell lymphoma: a comparison of Southern blot and polymerase chain reaction methods.Arch Dermatol. 2005 Sep;141(9):1107-13. doi: 10.1001/archderm.141.9.1107. Arch Dermatol. 2005. PMID: 16172307
-
Therapeutic approaches in cutaneous lymphoma.Dermatol Clin. 1994 Apr;12(2):433-41. Dermatol Clin. 1994. PMID: 8045054 Review.
-
Pathogenesis of cutaneous T-cell lymphoma: implications for the use of recombinant cytokines and photopheresis.Clin Exp Immunol. 1997 Jan;107 Suppl 1:16-20. Clin Exp Immunol. 1997. PMID: 9020930 Review.
Cited by
-
Skin effector memory T cells do not recirculate and provide immune protection in alemtuzumab-treated CTCL patients.Sci Transl Med. 2012 Jan 18;4(117):117ra7. doi: 10.1126/scitranslmed.3003008. Sci Transl Med. 2012. PMID: 22261031 Free PMC article.
-
Restoration of peripheral blood T cell repertoire complexity during remission in advanced cutaneous T cell lymphoma.Arch Dermatol Res. 2010 Aug;302(6):453-9. doi: 10.1007/s00403-009-1023-x. Epub 2010 Jan 29. Arch Dermatol Res. 2010. PMID: 20111968 Free PMC article.
-
Systemic Treatment Options for Advanced-Stage Mycosis Fungoides and Sézary Syndrome.Curr Oncol Rep. 2018 Mar 23;20(4):32. doi: 10.1007/s11912-018-0678-x. Curr Oncol Rep. 2018. PMID: 29572582 Review.
-
Cutaneous T-cell lymphoma (CTCL): Current practices in blood assessment and the utility of T-cell receptor (TCR)-Vβ chain restriction.J Am Acad Dermatol. 2016 May;74(5):870-7. doi: 10.1016/j.jaad.2015.12.018. Epub 2016 Feb 10. J Am Acad Dermatol. 2016. PMID: 26874819 Free PMC article.
-
Flow cytometric immunophenotypic assessment of T-cell clonality by vβ repertoire analysis in fine-needle aspirates and cerebrospinal fluid.Am J Clin Pathol. 2012 Feb;137(2):220-6. doi: 10.1309/AJCPPT93VZMAREHK. Am J Clin Pathol. 2012. PMID: 22261447 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
