title: Specific IgE toward allergenic molecules is a new prognostic marker in patients with Sézary syndrome.
abstract: BACKGROUND
  Sézary syndrome (SS) is the aggressive leukemic form of cutaneous T cell lymphoma characterized by erythroderma, the presence of a malignant circulating T memory cells with skin homing potential, and the ability to produce a variety of Th2 soluble factors, such as IL-4 and IL-5. We measured total and specific IgE in SS patients as a further parameter of a Th2-skewed immune system, and studied their clinical impact.
  
  
  METHODS
  Specific IgE production in a cohort of 55 SS patients was evaluated by the molecule-based ISAC microarray system. We then evaluated survival times and the hazard ratios in this cohort by Kaplan-Meier and Cox methods.
  
  
  RESULTS
  Twenty-four (43.6%) SS patients had specific IgE to both environmental and food allergens. For survival analysis, patients found positive to at least one allergen were defined as IgE+. By comparing IgE+ versus IgE- we found a significant difference in the median survival times, 2.9 versus 8.9 years (p < 0.001). Conversely, no survival difference could be observed when total IgE levels were considered. IgE+ patients had higher levels of CD60+CD49-CD4+ T cells, which also represent another worse prognostic index recently identified.
  
  
  CONCLUSIONS
  SS patients had specific IgE to both environmental and food allergens. IgE+ SS patients had a significant lower survival rate. High levels of CD60-CD49+CD4+ T cells associated with an IgE- phenotype allow the identification of a restricted group of long survivor SS patients. Therefore, specific measurement of IgE seems to be useful in discriminating survival.
authors: Center for Molecular Allergology, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy. e.scala@idi.it
authors: Enrico
authors: E
authors: Scala
authors: Damiano
authors: D
authors: Abeni
authors: Paola
authors: P
authors: Palazzo
authors: Marina
authors: M
authors: Liso
authors: Debora
authors: D
authors: Pomponi
authors: Giuseppe
authors: G
authors: Lombardo
authors: Maria Cristina
authors: MC
authors: Picchio
authors: Maria Grazia
authors: MG
authors: Narducci
authors: Giandomenico
authors: G
authors: Russo
authors: Adriano
authors: A
authors: Mari
mesh_terms: D000368:Aged; D000485:Allergens / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology*; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012751:Sezary Syndrome / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D000485:Allergens; D007073:Immunoglobulin E