Peripheral blood involvement in a mycosis fungoides patient with limited skin lesions: phenotypical features and homing molecule pattern.
Peripheral blood involvement in mycosis fungoides (MF) patients is more frequent in the advanced stages and is associated with a worse prognosis. We report a MF patient with limited patch lesions on her shoulders, upper chest and thighs (T2N0M0) and peripheral blood involvement. Clonality in the peripheral blood was demonstrated by the PCR assay and confirmed by the expansion of the same restricted variable region of the TCR beta-chain (vbeta17) expressed in the cutaneous infiltrate. The patient was treated with fludarabine achieving a complete hematological response followed by an early relapse, whilst the cutaneous lesions remained unchanged. The soluble interleukin-2 receptor levels showed a decrease from baseline levels down to normal values at hematological remission, followed by a further increase. The low sLex/CLA expression in the cutaneous lymphoid infiltrate could have given rise to a higher recruitment in the peripheral blood.
Quaglino
P
P
Department of Medical and Surgical Specialties, Section of Dermatology, 1st Dermatologic Clinic, University of Turin, via Cherasco 23, 10126 Turin, Italy.
Osella-Abate
S
S
Novelli
M
M
Lisa
F
F
Comessatti
A
A
Bernengo
M G
MG
D000368:Aged; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007962:Leukocytes / Q000166:cytology; D008214:Lymphocytes / Q000473:pathology; D008854:Microscopy, Electron / Q000379:methods; D009182:Mycosis Fungoides / Q000097:blood* / Q000276:immunology / Q000473:pathology*; D010641:Phenotype; D016133:Polymerase Chain Reaction / Q000379:methods; D015375:Receptors, Interleukin-2 / Q000187:drug effects; D012782:Shoulder; D012878:Skin Neoplasms / Q000097:blood* / Q000276:immunology / Q000473:pathology*; D013848:Thigh; D013909:Thorax; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D014740:Vidarabine; C024352:fludarabine