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- Title
Evidence that an Identical T Cell Clone in Skin and Peripheral Blood Lymphocytes is an Independent Prognostic Factor in Primary Cutaneous T Cell Lymphomas.
- Authors
Beylot-Barry, Marie; Sibaud, Vincent; Thiebaut, Rodolphe; Vergier, Béatrice; Beylot, Claire; Delaunay, Michèle; Chene, Geneviève; Dubus, Pierre; Merlio, Jean Philippe
- Abstract
The monoclonality of the T cell receptor γ-chain gene was analyzed by polymerase chain reaction in skin and blood specimens of 85 patients with cutaneous T cell lymphomas including 67 mycosis fungoides, seven Sézary syndromes, and 11 CD30- nonepidermotropic cutaneous T cell lymphomas. A cutaneous T cell clone was detected in 69% of mycosis fungoides and 100% of Sézary syndromes. This frequency varied according to the clinical stage: 57% in early stages (Ia-IIa) to 96% in advanced stages (IIb-IV, Sézary syndrome). A peripheral blood T cell clone was detected in 42% of early stages and in 74% of late stages but was identical to the cutaneous one in 15% and in 63%, respectively. A significant association between initial clinical stage and T cell monoclonality was observed. In nonepidermotropic cutaneous T cell lymphomas, T cell monoclonality was detected in 55% of skin and 36% of blood samples. Univariate and multivariate analyses showed that, besides the initial clinical stage, an identical cutaneous and blood T cell clone was an independent prognostic factor for disease progression of mycosis fungoides/Sézary syndrome (hazard ratio 3.4, 95% confidence interval 1.4–9.9). Parallel polymerase chain reaction study of skin and blood specimens may therefore provide an initial prognostic marker that could help to monitor therapeutic strategies. A fully prospective study, with simultaneous therapeutic trials, needs to be done to confirm our findings and to include treatment variables in the statistical analysis.
- Subjects
LYMPHOMAS; GENES; T cells; ANALYTICAL chemistry; PROGNOSIS
- Publication
Journal of Investigative Dermatology, 2001, Vol 117, Issue 4, p920
- ISSN
0022-202X
- Publication type
Article
- DOI
10.1046/j.0022-202X.2001.01476.x