title: Does fluorescence diagnosis have a role in follow up of response to therapy in mycosis fungoides?
abstract: BACKGROUND
  Monitoring of tumor burden during mycosis fungoides (MF) treatment, is crucial to adjust therapy accordingly. This is usually achieved through combined by clinical assessment with histopathological and immunohistochemical evaluation.
  
  
  OBJECTIVE
  To assess the validity of fluorescence diagnosis (FD) in the measurement of response to therapy in early MF, using in comparison flow cytometric technique of skin biopsies for CD4+/CD7- malignant T-cell count before and after therapy.
  
  
  METHODS
  Twenty-two patients of histologically proven early MF (stages Ia, Ib, IIa) were subjected to fluorescence diagnosis of their most affected skin lesion before and after 12 weeks of phototherapy with or without combination therapy. In comparison flow cytometric assessment of skin biopsies for CD4+/CD7- malignant T-cell count was evaluated before and after therapy from skin biopsy of the same lesion.
  
  
  RESULTS
  All tested MF lesions showed varying degrees of fluorescence by FD at week zero, with a mean accumulation factor (AF), which is the fluorescence ratio between the tumor tissue and normal skin, of 2.2. After 12 weeks of therapy, the mean AF showed significant reduction to 1.94 (p=0.009). The percent of CD4+/CD7- cells dropped significantly after treatment (p=0.029). No correlation between CD4+/CD7- cell counts and the mean AF could be deduced.
  
  
  CONCLUSIONS
  In cases of mycosis fungoides, fluorescence diagnosis can represent an effective tool for evaluating the response to therapy. Changes in accumulation factor values can be used for follow-up of therapy in the same patient, but it should not be used as an absolute value.
authors.affiliation: Dermatology Department, Cairo University, Cairo, Egypt. Electronic address: manal.bosseila@kasralainy.edu.eg.
authors.forename: Manal
authors.initials: M
authors.lastname: Bosseila
authors.affiliation: Dermatology Department, Cairo University, Cairo, Egypt.
authors.forename: Doaa
authors.initials: D
authors.lastname: Mahgoub
authors.affiliation: Pathology Department, National Cancer Institute, Cairo, Egypt.
authors.forename: Abeer
authors.initials: A
authors.lastname: El-Sayed
authors.affiliation: Dermatology Department, Cairo University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Salama
authors.affiliation: Pathology Department, National Research Center, Cairo, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Abd El-Moneim
authors.affiliation: Dermatology Department, National Research Center, Cairo, Egypt.
authors.forename: Fatma
authors.initials: F
authors.lastname: Al-Helf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid; D003287:Contrast Media; D046169:Dermoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence / Q000379:methods*; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000473:pathology* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003287:Contrast Media; D000622:Aminolevulinic Acid
keywords: CD4+/CD7− T cells; Flowcytometry; Fluorescence diagnosis; Mycosis fungoides