CD4+/CD7- T cell frequency and polymerase chain reaction-based clonality assay correlate with stage in cutaneous T cell lymphomas

JOURNAL OF INVESTIGATIVE DERMATOLOGY

卷:114

Article

Laetsch, B ; Häffner, AC ; Döbbeling, U ; Seifert, B ; Ludwig, E ; Burg, G ; Dummer, R

关键词: CD7(-) antigen loss;    clonality;    cutaneous T cell lymphoma;    mycosis fungoides;    Sezary syndrome;    T cell receptor;   

DOI  :  10.1046/j.1523-1747.2000.00818.x

来源: Elsevier

【 摘 要 】

In cutaneous T cell lymphomas, tumor cells can be found in skin and in other compartments. A precise definition of extracutaneous spread including blood involvement is necessary for staging and treatment design. We investigated peripheral blood in 51 patients with various types of cutaneous T cell lymphomas by the analysis of blood smears for Sezary cells, the CD4(+)/CD7(-) T helper cell frequency in the peripheral blood by fluorescence activated cell sorter analysis and by polymerase chain reaction for the T cell receptor gamma-chain followed by denaturing gradient gel electrophoresis. Eleven polymerase chain reaction products were sequenced. Thirty-five per cent of patients with stage Ia-IIb cutaneous T cell lymphomas presented a peripheral blood T cell clone. In patients with stage III-IVb cutaneous T cell lymphomas 75% were positive for clonality in the peripheral blood by polymerase chain reaction. Interestingly, three of 13 Sezary patients showed a TCR-gamma joining region pseudogene (J gamma P1/J gamma P2) usage. CD4(+)/CD7(-) cell counts were significantly higher in patients with advanced cutaneous T cell lymphomas than in patients with early cutaneous T cell lymphomas. There was a correlation between increased percentage of circulating CD4(+)/CD7(-) cells and detection of clonality by polymerase chain reaction (p = 0.001). There was no significant correlation between the polymerase chain reaction data and the percentage of Sezary cells on blood smears. A significant correlation between CD4(+)/CD7(-) cells and Sezary cells was found, however. Stepwise logistic regression analysis showed that the CD4(+)/CD7(-) cell count and clonal T cell detection in peripheral blood are independently correlated with stage. The combination of both parameters gives more information than each one separately. In conclusion, our data indicate that fluorescence activated cell sorter analysis of peripheral blood and polymerase chain reaction-based clonality assays can improve the accuracy of staging investigations in cutaneous T cell lymphomas patients.

【 授权许可】

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