Expression of apoptosis markers on peripheral blood lymphocytes from patients with cutaneous T-cell lymphoma during extracorporeal photochemotherapy.
The mechanisms of extracorporeal photochemotherapy (ExP) therapeutic activity in cutaneous T-cell lymphomas (CTCLs) are not yet well understood, even though it has been suggested that a major mechanism may be induction of apoptosis. In vitro studies demonstrate that UVA-induced apoptosis is mediated by CD95-Fas expression and inhibited by Bcl-2 up-regulation and that UVA irradiation is able to down-regulate Bcl-2 expression. High-resolution multiparameter flow-cytometric analyses were used to evaluate Bcl-2/CD95-Fas expression on phenotypically identifiable circulating clonal T cells from 7 patients with CTCL (4 with Sézary syndrome and 3 with mycosis fungoides with peripheral involvement) before and during ExP, in an attempt to ascertain whether Bcl-2/CD95-Fas status can be related to the hematologic response. A Bcl-2 normal phenotype before ExP or a normalization in Bcl-2 expression during ExP were related to a better clinical response, whereas a persistent Bcl-2 high expression was a negative prognostic factor. On the other hand, no response was found in patients with a CD95-Fas-negative phenotype, whereas the expression of CD95-Fas was associated with hematologic remission. Although further studies are needed to confirm these preliminary results, this study suggests that Bcl-2 and CD95-Fas expression could be evaluated, together with the other known clinical and immunologic factors, as additional parameters related to clinical response in patients with CTCL undergoing ExP.
Osella-Abate
S
S
Department of Medical and Surgical Specialties, 1st Dermatologic Clinic, University of Torino.
Zaccagna
A
A
Savoia
P
P
Quaglino
P
P
Salomone
B
B
Bernengo
M G
MG
D000328:Adult; D000368:Aged; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood*; D015536:Down-Regulation; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement; D019672:Genes, T-Cell Receptor; D006801:Humans; D008214:Lymphocytes / Q000737:chemistry*; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy / Q000276:immunology; D010778:Photochemotherapy / Q000379:methods*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000097:blood*; D012751:Sezary Syndrome / Q000188:drug therapy / Q000276:immunology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology*; D019014:fas Receptor / Q000097:blood*
D015415:Biomarkers; D019253:Proto-Oncogene Proteins c-bcl-2; D019014:fas Receptor