title: Evaluation of blood parameters for the monitoring of erythrodermic cutaneous T-cell lymphoma.
abstract: OBJECTIVE
  Erythrodermic cutaneous T-cell lymphomas are aggressive diseases posing diagnostic and therapeutic challenges. Numerous indicators for confirming diagnosis and disease-monitoring have been proposed. CD26-negativity of peripheral CD4+ T-cells has been reported to have these properties. Our aim was to test, if the CD4(+) T-cell count, fraction of CD26- or CD7-negative CD4+ T-cells during the course of disease are valuable markers to predict therapeutic efficacy or disease progression in relation to changes in skin status.
  
  
  METHODS
  Retrospective cohort analysis of eleven patients treated at a tertiary referral centre. Statistics were done by linear regression analysis and logrank test.
  
  
  RESULTS
  Five patients displayed response to therapy in the skin, nine in the blood. Patients with cutaneous response showed a decrease of CD4+ T-cells, preceding the clinical response in most patients, whereas the percentage of CD26-negative T-cells changed first during clinical improvement. The calculated positive predictive values for response or progression were low for both CD4-count and CD26-expression.
  
  
  CONCLUSIONS
  CD26 is not a reliable marker of either response or progression. As cutaneous response was always associated with a response in blood and not vice versa, we conclude, that the clinical status represents the most important parameter for guiding therapeutic decisions.
authors: Skin cancer centre Charité, Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany.
authors: Staffan
authors: S
authors: Vandersee
authors: Daniel
authors: D
authors: Humme
authors: Dorothea
authors: D
authors: Terhorst
authors: Anis
authors: A
authors: Almohamad
authors: Markus
authors: M
authors: Möbs
authors: Marc
authors: M
authors: Beyer
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D015704:CD4 Antigens / Q000097:blood; D018791:CD4 Lymphocyte Count / Q000379:methods; D015331:Cohort Studies; D018819:Dipeptidyl Peptidase 4 / Q000097:blood; D018450:Disease Progression; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D015704:CD4 Antigens; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4