Cardiac involvement and molecular staging in a fatal case of mycosis fungoides

Abstract

Polymerase chain reaction (PCR) amplification of T-cell receptor-gamma gene rearrangement was used for molecular staging in a case of primary cutaneous T-cell lymphoma (CTCL) with fatal evolution. Although initial evaluation was negative for systemic involvement, the patient died due to heart failure. Autopsy findings revealed lymphomatous myocardial infiltration, but other tissues and organs examined, including lymph nodes, liver, spleen, lung and bone marrow, appeared to be free of disease. Molecular analysis from frozen samples obtained during the initial evaluation, as well as paraffin-embedded material obtained during autopsy, revealed the presence of clonal rearranged bands in all tissues examined except the bone marrow. Subsequent hybridization of PCR products with a tumour-specific oligoprobe confirmed the PCR results, suggesting widespread dissemination of the lymphomatous process. The use of molecular analysis can add significant information about the extent of disease in patients with CTCL and may be helpful in the establishment of therapeutic options.

Cardiac toxicity of alemtuzumab in patients with mycosis fungoides/Sézary syndrome

“…Although cardiac involvement of lymphoma is rare, 20 autopsy studies of subjects with MF revealed a 15% to 30% incidence of cardiac involvement. [21][22][23] Another study reported gross cardiac involvement in 7 of 12 subjects. 24 Therefore, the potential direct effect of alemtuzumab on T cells residing in the myocardium remains a possibility.…”

Cardiac toxicity: old and new issues in anti-cancer drugs

“…Although cardiac involvement of lymphoma is rare, autopsy studies of subjects with MF/SS revealed a 15-30% incidence of cardiac involvement. Therefore, the potential direct effect of alemtuzumab on T cells residing in the myocardium remains a possibility [109].…”