title: Gamma-delta T-cell phenotype is associated with significantly decreased survival in cutaneous T-cell lymphoma.
abstract: The importance of alpha beta versus gamma delta T-cell subset antigen expression in the classification of peripheral T-cell lymphomas is still unclear. The objective of this study was to investigate the prognostic value of T-cell receptor-delta 1 (TCR delta 1) expression in primary cutaneous T-cell lymphomas. TCR delta 1 cellular expression was assessed in skin biopsy specimens of 104 individuals with cutaneous T-cell lymphoma by immunohistochemistry. Both univariate (Kaplan-Meier) and multivariate (Cox regression) analyses were conducted to determine which variables (T-cell subtype, hemophagocytosis, histologic profile, age, sex, and adenopathy) were significantly associated with survival. Univariate analysis indicated that there was a statistically significant difference in survival between the patients with alpha beta cutaneous T-cell lymphoma and patients with gamma delta cutaneous T-cell lymphoma (P <.0001). There was also a statistically significant decrease in survival among patients who had subcutaneous involvement compared with patients who had epidermotropic and/or dermal involvement (P <.0001). Cox model analysis indicated that TCR delta 1 expression was the factor that was most closely associated with decreased survival (P <.0001). Among those patients with cutaneous gamma delta T-cell lymphoma (n = 33), there was a trend for decreased survival for patients who had histologic evidence of subcutaneous fat involvement in comparison with patients who had epidermotropic or dermal patterns of infiltration (P =.067). No other prognostic factors were identified as having a notable association with outcome in this subgroup. TCR delta 1 expression in primary cutaneous lymphomas is an independent prognostic factor associated with decreased survival.
authors.affiliation: Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7231, USA. torojo@exchange.nih.gov
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Toro
authors.forename: David J
authors.initials: DJ
authors.lastname: Liewehr
authors.forename: Nina
authors.initials: N
authors.lastname: Pabby
authors.forename: Lynn
authors.initials: L
authors.lastname: Sorbara
authors.forename: Mark
authors.initials: M
authors.lastname: Raffeld
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: Elaine S
authors.initials: ES
authors.lastname: Jaffe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D015993:Life Tables; D008198:Lymph Nodes / Q000473:pathology; D016410:Lymphoma, T-Cell, Cutaneous / Q000097:blood / Q000276:immunology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000276:immunology; D011379:Prognosis; D016016:Proportional Hazards Models; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis*; D012878:Skin Neoplasms / Q000097:blood / Q000276:immunology / Q000401:mortality*; D016019:Survival Analysis; D016176:T-Lymphocyte Subsets / Q000737:chemistry / Q000276:immunology
chemical_list: D009363:Neoplasm Proteins; D016692:Receptors, Antigen, T-Cell, gamma-delta