A prospective study on the evolution of the T-cell repertoire in patients with Sézary syndrome treated by extracorporeal photopheresis.
Sézary syndrome is a leukemic form of epidermotropic cutaneous T-cell lymphoma related to the malignant proliferation of clonal CD4(+) T cells. Extracorporeal photochemotherapy may induce a transient improvement of the clinical signs, but its efficiency is discussed. To investigate the frequency of the T-cell clone in the peripheral blood of patients with Sézary syndrome and to monitor its evolution in patients treated using extracorporeal photopheresis or chemotherapy, we used the immunoscope technique. In one patient, we observed a decrease of the relative frequency of the clone from 15.6% to 0%, paralleling a complete remission of the clinical disease and a disappearance of the circulating Sézary cells. In the other cases, the evolution of the relative frequency paralleled the initial improvement of the clinical status and the absence of long-term efficiency in patients treated with extracorporeal photopheresis or chemotherapy. We observed a quick-acting direct cytotoxicity of the association 8MOP + UVA on the T-cell clone. The immunoscope technique appears to be an efficient tool to appreciate the amount of tumoral cells and to monitor the evolution of the clonal component in the Sézary syndrome.
Institut de Recherche sur la Peau, Institut National de la Santé et de la Recherche Médicale (INSERM) U532, Hôpital Saint-Louis, 75475 Paris, France.
Saskia
S
Ingen-Housz-Oro
Annette
A
Bussel
Béatrice
B
Flageul
Laurence
L
Michel
Louis
L
Dubertret
Philippe
P
Kourilsky
Gabriel
G
Gachelin
Hervé
H
Bachelez
Philippe
P
Musette
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002999:Clone Cells / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D022801:Complementarity Determining Regions; D005260:Female; D019674:Genes, T-Cell Receptor beta; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012751:Sezary Syndrome / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D016896:Treatment Outcome
D022801:Complementarity Determining Regions