Circulating CD8+ lymphocytes, white blood cells, and survival in patients with mycosis fungoides

Abeni, Damiano; Frontani, Marina; Sampogna, Francesca; Sera, Francesco; Bolli, Simone; Corona, Rosamaria; Baliva, Giannandrea; Russo, Giandomenico

doi:10.1111/j.1365-2133.2005.06755.x

Cited by 45 publications

(32 citation statements)

References 32 publications

(34 reference statements)

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“…9 Low numbers of CD8 ϩ T cells in the dermal infiltrate and/or the blood have also been independently associated with reduced survival. 14,20,21 Managing early-stage (IA-IIA) MF…”

Section: B2mentioning

confidence: 99%

How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

136

109

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The most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.

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“…9 Low numbers of CD8 ϩ T cells in the dermal infiltrate and/or the blood have also been independently associated with reduced survival. 14,20,21 Managing early-stage (IA-IIA) MF…”

Section: B2mentioning

confidence: 99%

How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

136

109

View full text Add to dashboard Cite

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“…[13][14][15][16][17][18][19][20] However, none of these markers is directly associated with the tumor phenotype of the SS cells and they seem to be mere markers of risk or, at best, the result of some deregulated mechanisms. Here we describe, for the first time, the prognostic significance of two antigens directly related to T-cell function, and thus possibly involved in the pathogenesis of SS.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,11,12 Previous studies of prognostic indicators in SS showed that circulating Sézary cell count, high CD4/CD8 ratio, advanced age, high lactate dehydrogenase serum level and a high white blood cell count were associated with an unfavorable outcome. [13][14][15][16][17][18][19][20] Up to now, scanty data have been provided concerning possible associations between the immunophenotype of circulating CD4 + T cells and survival in SS. As for other hematologic malignancies, 21,22 it is important to clarify the prognostic relevance of activation of homing receptors expressed by circulating CD4 + T cells in SS, since these markers might be directly linked to the pathogenesis and outcome of the disorder.…”

Section: Introductionmentioning

confidence: 99%

The role of 9-O-acetylated ganglioside D3 (CD60) and 4 1 (CD49d) expression in predicting the survival of patients with Sezary syndrome

Scala

Abeni²,

Pomponi³

et al. 2010

Haematologica

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BackgroundSézary syndrome is a rare and very aggressive leukemic variant of cutaneous T-cell lymphoma characterized by extensive skin involvement and a malignant circulating CD4 + T-cell clone which homes to the skin, over-expresses CD60, and lacks CD7, CD26 and CD49d. So far prognostic markers in this disease are limited to treatment with systemic steroids, age, serum lactate dehydrogenase, and a white blood cell count of 20¥10 9 /L or higher: no other biological marker with prognostic value, especially related to malignant cells, has been described. Design and MethodsWe used flow activated cell sorting analysis to compare the distribution of the T-cell receptor-Vβ repertoire and several surface molecules (CD7, CD26, CD49d and CD60) within the circulating CD4 + T-cell population in 62 patients with Sézary syndrome, 180 with mycosis fungoides, 6 with B-cell lymphomas, and 19 with chronic eczema. We calculated the 5-year overall survival of patients with Sézary syndrome after first hospital admission using Kaplan-Meier product-limit estimates and hazard ratios from the Cox proportional hazards model. ResultsWe found that both higher number of CD60 + and lower number of CD49d + cells within circulating CD4 + T cells at disease presentation were significantly associated with a lower probability of survival. An exceedingly high risk of death was observed for patients with a combination of a high proportion of CD4 /L) (hazard ratio = 12.303, 95% confidence interval 1.5-95.9; P<0.02). In addition, a skewed usage of T-cell receptor-Vβ subfamilies was observed in the circulating T-cell clone for 61.9% of all patients with Sézary syndrome, T-cell receptor-Vβ 2 and 5.1 subfamilies being the most frequently represented (42.8%), followed by T-cell receptor-Vβ 12 and 13.1. ConclusionsIn this study we showed that up-regulation of CD60 and down-regulation of CD49d on circulating CD4 + T cells are two useful markers for predicting a very poor outcome in patients with Sézary syndrome.Key words: TCR-Vβ repertoire, CD60, CD49d, survival rate, Sézary syndrome. Haematologica 2010;95(11):1905-1912. doi:10.3324/haematol.2010 This is an open-access paper.The role of 9-O-acetylated ganglioside D3 (CD60) and α4β1 (CD49d) expression in predicting the survival of patients with Sézary syndrome

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“…Other prognostic factors, whether laboratory or histopathologically based, have also been identified, such as significant tissue CD30+ expression (suggesting large cell transformation), decreased tissue CD8+ expression, elevated LDH, significant peripheral blood burden of malignant cells, and blood eosinophilia. In the past year, a study showed that decreased peripheral blood CD8 T-cell count (<250 cells/μL) and elevated total leukocyte count (>9000 cells/μL) correlated with worse OS [22].…”

Section: Mycosis Fungoides and Variants/subtypesmentioning

confidence: 99%

Mycosis fungoides and sezary syndrome: An update

Kim

Lin²,

Junkins‐Hopkins³

et al. 2006

Curr Oncol Rep

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Mycosis fungoides (MF), and the associated leukemic variant Sezary Syndrome (SS), are the most common group of cutaneous T-cell lymphomas. MF/SS is a non-Hodgkin's lymphoma of mature, skin-homing, clonal, malignant T lymphocytes that initially presents in the skin as patches, plaques, tumors, or generalized erythema (erythroderma) and can involve the lymph nodes and peripheral blood. Much progress has been made in recent years in understanding the origin of the malignant T cell in MF/SS and the pathophysiology and immunology of the disease. This recent work has made a great impact on diagnosis, prognostication, and treatment. In this review, we survey the MF/SS published literature over the past year and highlight some of the important advances.

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Circulating CD8+ lymphocytes, white blood cells, and survival in patients with mycosis fungoides

Abstract: The measurement of CD8+ cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.

Cited by 45 publications

References 32 publications

How I treat mycosis fungoides and Sézary syndrome

How I treat mycosis fungoides and Sézary syndrome

The role of 9-O-acetylated ganglioside D3 (CD60) and 4 1 (CD49d) expression in predicting the survival of patients with Sezary syndrome

Mycosis fungoides and sezary syndrome: An update

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