title: Extracorporeal photopheresis of cutaneous T-cell lymphoma is associated with reduction of peripheral CD4+ T lymphocytes.
abstract: BACKGROUND
  Extracorporeal photopheresis (ECP) has been successfully introduced for the treatment of cutaneous T-cell lymphoma; however, the mechanism(s) of its action is (are) unknown.
  
  
  OBJECTIVE
  To investigate the effects of ECP on the immune system of patients with cutaneous T-cell lymphoma.
  
  
  METHODS
  Clinical response and changes of lymphocyte subpopulations in 20 patients with cutaneous T-cell lymphoma under ECP monotherapy or combined regimens were evaluated and compared after 3, 6 and 12 ECP cycles.
  
  
  RESULTS
  Thirteen of 20 patients showed a > or = 50% reduction of skin lesions after 6-12 ECP cycles. An overall T-lymphocyte reduction was assessed with a balanced CD4+ T-helper and CD8+ T-suppressor cell decrease in responders. In contrast, there was a trend of CD4+ T-helper cell increase in nonresponders which could result from the failure of treatment to control the natural course of the disease. The CD4+/CD8+ ratios were 1.6 at baseline and 1.4 after 12 cycles in responders, while they increased from 1.7 to 4.1 in nonresponders, respectively (p = 0.47). In addition, there was an overall decrease in the CD57+/CD8+ T-cell subpopulation mostly due to a reduction in the responder group.
  
  
  CONCLUSIONS
  The marked differences detected in certain T-cell subpopulations suggest an effect of ECP on peripheral T lymphocytes and, especially, on CD4+ cells.
authors.affiliation: Department of Dermatology, University Medical Center Benjamin Franklin, Free University of Berlin, Germany. zoubbere@zedat.fu-berlin.de
authors.forename: C C
authors.initials: CC
authors.lastname: Zouboulis
authors.forename: M
authors.initials: M
authors.lastname: Schmuth
authors.forename: S
authors.initials: S
authors.lastname: Doepfmer
authors.forename: E
authors.initials: E
authors.lastname: Dippel
authors.forename: C E
authors.initials: CE
authors.lastname: Orfanos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D012878:Skin Neoplasms / Q000276:immunology* / Q000628:therapy; D016896:Treatment Outcome