Minimal residual disease in mycosis fungoides follow-up can be assessed by polymerase chain reaction.
BACKGROUND
T-cell receptor (TCR) gene rearrangement analysis, i.e. T-cell clonality, using polymerase chain reaction (PCR) is a routine method used to assess the presence of a cutaneous dominant T-cell clone in mycosis fungoides (MF).


OBJECTIVE
To compare the outcome of cutaneous lesions of MF after treatment with the fate of the cutaneous T-cell clonality, and to determine whether minimal residual disease can be detected in patients in clinical complete remission.


METHODS
Fifty-one patients histologically diagnosed as having MF (17 stage IA, 21 stage IB and 13 stage III) were included in this retrospective study. T-cell clonality was analysed by GC-clamp multiplex PCRgamma-denaturing gradient gel electrophoresis. Every patient had two cutaneous biopsies at least 3 months apart. The second biopsy was performed at the site of a treated lesion.


RESULTS
The presence or absence of a dominant T-cell clone in the skin remained identical in 26 of the 31 (84%) patients with persistent disease. Thirteen patients with a detectable dominant T-cell clone at diagnosis went into complete clinical remission. In nine of these 13 (69%) patients, the T-cell clone was no longer detectable after treatment. The remaining four (31%) patients had an unchanged T-cell clonality.


CONCLUSIONS
The TCR gene rearrangement imprint is a stable and reliable tumour marker of MF disease. One-third of patients in complete clinical remission had a cutaneous molecular residual disease, the prognostic value of which will be analysed in an ongoing prospective study.
Poszepczynska-Guigne
E
E
Department of Dermatology, Henri Mondor Hospital, University Paris XII, APHP, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France. ewa.guigne@libertysurf.fr
Bagot
M
M
Wechsler
J
J
Revuz
J
J
Farcet
J-P
JP
Delfau-Larue
M-H
MH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; D019675:Genes, T-Cell Receptor gamma / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction / Q000379:methods; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013601:T-Lymphocytes