title: Minimal residual disease in mycosis fungoides follow-up can be assessed by polymerase chain reaction.
abstract: 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.
authors.affiliation: 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
authors.forename: E
authors.initials: E
authors.lastname: Poszepczynska-Guigne
authors.forename: M
authors.initials: M
authors.lastname: Bagot
authors.forename: J
authors.initials: J
authors.lastname: Wechsler
authors.forename: J
authors.initials: J
authors.lastname: Revuz
authors.forename: J-P
authors.initials: JP
authors.lastname: Farcet
authors.forename: M-H
authors.initials: MH
authors.lastname: Delfau-Larue
mesh_terms: 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