Circulating CD4+CD7− Lymphocyte Burden and Rapidity of Response

Stevens, Seth R.; Baron, Elma D.; Masten, Susan J.; Cooper, Kevin D.

doi:10.1001/archderm.138.10.1347

Cited by 29 publications

(5 citation statements)

References 16 publications

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“…However, important prognostic information was derived from this study as they demonstrated that early response to ECP after six to eight cycles had 100% sensitivity and 90% specificity for predicting outcome beyond 4 years (12). This supports the data by Wollina and colleagues, who found that patients with stage IIA/IIB CTCL experienced their best response to therapy within the first 6 months of treatment (26, 44). Such observations provide a timeframe for response beyond which that subset of patients who demonstrate minimal or no response to ECP may not benefit from continued therapy (1).…”

Section: Prognostic Variables That Influence Response To Ecp Treatmentsupporting

confidence: 90%

“…Early studies have agreed that the best responders to ECP have features such as absence of bulky lymphadenopathy or major internal organ involvement; discrete number of Sézary cells (10–20% of mononuclear cells); short duration of disease (preferably <2 years); close to normal CD4:CD8 ratios; normal or close to normal natural killer cell activity; limited leukocytosis/leukemia (WBC <20,000 per mm 3 ); response within 5 months of treatment; and minimal plaque‐stage disease (<10–15% of total skin surface) (10, 13, 15, 16, 22, 25, 26, 46, 47). Most of these criteria require that the patient possesses sufficient immunologic reserve to mount an anti‐tumor response (16).…”

Section: Prognostic Variables That Influence Response To Ecp Treatmentmentioning

confidence: 99%

“…The precise mechanism underlying the observed efficacy of ECP as a therapy for CTCL remains to be elucidated (1, 10, 16, 19, 20, 22–27). UV light induces the formation of thymine dimers, which interferes with DNA replication, and 8‐MOP potentiates the skin response to UV light, resulting in the selective promotion of apoptosis in malignant or activated lymphocytes (28).…”

mentioning

confidence: 99%

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Review of extracorporeal photopheresis in early‐stage (IA, IB, and IIA) cutaneous T‐cell lymphoma

Miller

Kirkland

Domingo

et al. 2007

Photoderm Photoimm Photomed

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Section: Prognostic Variables That Influence Response To Ecp Treatmentsupporting

confidence: 90%

Section: Prognostic Variables That Influence Response To Ecp Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Review of extracorporeal photopheresis in early‐stage (IA, IB, and IIA) cutaneous T‐cell lymphoma

Miller

Kirkland

Domingo

et al. 2007

Photoderm Photoimm Photomed

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“…Sezary syndrome (SS) is the leukemic form of CTCL, involving the skin, lymph nodes, and peripheral blood. Patients with SS can have detectable levels of the leukemic T cells (Sezary cells) in their circulation, and the immunophenotype of these cells is often characterized by the expression of CD4 and absence of CD7 [20, 21]. In this study, we investigated the susceptibility of malignant T-lymphocytes that characterizes SS to the phototoxic effects of Pc 4-PDT ex vivo, and the effect of Pc 4-PDT in vivo to damage the antiapoptotic protein Bcl-2 in the skin lesions of MF.…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Therapy with the Silicon Phthalocyanine Pc 4 Induces Apoptosis in Mycosis Fungoides and Sezary Syndrome

Lam

Lee

Deng

et al. 2010

Advances in Hematology

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Our current focus on the effects of Photodynamic Therapy (PDT) using silicon phthalocyanine Pc 4 photosensitizer on malignant T lymphocytes arose due to preclinical observations that Jurkat cells, common surrogate for human T cell lymphoma, were more sensitive to Pc 4-PDT-induced killing than epidermoid carcinoma A431 cells. Mycosis fungoides (MF) as well as Sezary syndrome (SS) are variants of cutaneous T-cell lymphoma (CTCL) in which malignant T-cells invade the epidermis. In this study, we investigated the cytotoxicity of Pc 4-PDT in peripheral blood cells obtained from patients with SS and in skin biopsies of patients with MF. Our data suggest that Pc 4-PDT preferentially induces apoptosis of CD4+CD7− malignant T-lymphocytes in the blood relative to CD11b+ monocytes and nonmalignant T-cells. In vivo Pc 4-PDT of MF skin also photodamages the antiapoptotic protein Bcl-2.

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“…Clinical parameters that have been associated with sustained beneficial responses of CTCL to ECP include short disease durations (early treatment) and clinical improvement before 6 months (9, 25, 26). Laboratory parameters that have been reported to be correlated with favorable responses to ECP include (1) near‐normal CD4/CD8 ratios or absolute number of CD8+ cells in the peripheral blood (9, 27), (2) the presence of modest numbers of Sézary cells (28), and (3) relatively low percentages of CD4+CD7− T cells, a phenotype that is often expressed by neoplastic T cells (25).…”

mentioning

confidence: 99%

Predictors of response to extracorporeal photopheresis in advanced mycosis fungoides and Sézary syndrome

McGirt¹,

Thoburn

Hess

et al. 2010

Photodermatology, Photoimmunology &Amp; Photomedicine

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Summary Background Extracorporeal photopheresis (ECP) has been utilized for more than 20 years to treat cutaneous T-cell lymphoma (CTCL), but a clinical response can take up to 9 months to manifest. This study was undertaken to determine whether clinical features, laboratory values, cytokine levels, or gene expression levels of tumor markers are useful to predict the subsequent response to ECP in CTCL patients with blood involvement. Methods Twenty-one patients with CTCL treated with ECP as monotherapy for at least 6 months were retrospectively identified. Laboratory and clinical data and blood obtained at baseline, 3, and 6 months of treatment were used for analysis. Results In pretreatment blood specimens, a lower percentage of Sézary cells and a higher absolute eosinophil count were associated with a favorable clinical response. Clinical evidence of an early response after 3 months of ECP did not reliably predict a favorable response at 6 months or beyond. Comparison of cytokines, gene transcripts, and other laboratory measures of disease did not correlate with the subsequent clinical response, although lactate dehydrogenase levels tended to decrease progressively in ECP-responsive cases and increase progressively in ECP-non-responsive cases. Additionally, serum levels of TNF-α significantly increased from baseline to 6 months of ECP, but was not found to correlate with the clinical response. Conclusions Although we found that increased eosinophils and decreased percentage of Sézary cells were associated with a favorable clinical response to ECP, we were not able to identify the predictors of ECP response within the first 3 months of treatment.

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Circulating CD4+CD7− Lymphocyte Burden and Rapidity of Response

Cited by 29 publications

References 16 publications

Review of extracorporeal photopheresis in early‐stage (IA, IB, and IIA) cutaneous T‐cell lymphoma

Review of extracorporeal photopheresis in early‐stage (IA, IB, and IIA) cutaneous T‐cell lymphoma

Photodynamic Therapy with the Silicon Phthalocyanine Pc 4 Induces Apoptosis in Mycosis Fungoides and Sezary Syndrome

Predictors of response to extracorporeal photopheresis in advanced mycosis fungoides and Sézary syndrome

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