title: The effect of extracorporeal photopheresis alone or in combination therapy on circulating CD4(+) Foxp3(+) CD25(-) T cells in patients with leukemic cutaneous T-cell lymphoma.
abstract: OBJECTIVE
  Extracorporeal photopheresis (ECP) alone or in combination therapy is effective for treatment of leukemic cutaneous T-cell lymphoma (L-CTCL), but its mechanism(s) of action remain unclear. This study was designed to investigate the effect of ECP on regulatory T cells and CD8(+) T cells in L-CTCL patients.
  
  
  METHODS
  Peripheral blood from 18 L-CTCL patients at baseline, Day 2, 1 month, 3 month, and 6 month post-ECP therapy was analyzed by flow cytometry for CD4(+) CD25(+/high) , CD4(+) Foxp3(+) CD25(+/-) , CD3(+) CD8(+) , CD3(+) CD8(+) CD69(+) , and CD3(+) CD8(+) IFN-γ(+) T cells. Clinical responses were assessed and correlated with changes in these T-cell subsets.
  
  
  RESULTS
  Twelve of 18 patients achieved clinical responses. The average baseline number of CD4(+) CD25(+/high) T cells of PBMCs in L-CTCL patients was normal (2.2%), but increased at 6-month post-therapy (4.3%, P < 0.01). The average baseline number of CD4(+) Foxp3(+) T cells out of CD4(+) T cells in nine evaluable patients was high (66.8 ± 13.7%), mostly CD25 negative. The levels of CD4(+) Foxp3(+) T cells in responders were higher (n = 6, 93.1 ± 5.7%) than nonresponders (n = 3, 14.2 ± 16.0%, P < 0.01), and they declined in parallel with malignant T cells. The numbers of CD3(+) CD8(+) CD69(+) and CD3(+) CD8(+) IFN-γ(+) T cells increased at 3-month post-therapy in five of six patients studied.
  
  
  CONCLUSIONS
  Extracorporeal photopheresis alone or in combination therapy might be effective in L-CTCL patients whose malignant T cells have a CD4(+) Foxp3(+) CD25(-) phenotype.
authors.affiliation: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Graduate Program in Immunology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Shiue
authors.affiliation: Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.|Graduate Program in Virology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Couturier
authors.affiliation: Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.|Graduate Program in Virology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Dorothy E
authors.initials: DE
authors.lastname: Lewis
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Caimiao
authors.initials: C
authors.lastname: Wei
authors.affiliation: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Graduate Program in Immunology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ni
authors.affiliation: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Graduate Program in Immunology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology; D003131:Combined Modality Therapy; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology*; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D012189:Retrospective Studies; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000473:pathology
chemical_list: D015703:Antigens, CD; C573415:IFNG protein, human; D007371:Interferon-gamma
keywords: CD25; CD8+ T cells; Sézary syndrome; extracorporeal photopheresis; foxp3; mycosis fungoides; regulatory T cells