title: Frequency and prognostic value of cutaneous molecular residual disease in mycosis fungoides: a prospective multicentre trial of the Cutaneous Lymphoma French Study Group.
abstract: BACKGROUND
  Monoclonal T-cell receptor (TCR) rearrangement is detected in 57-75% of early-stage mycosis fungoides (MF) at diagnosis. A retrospective study showed molecular residual disease (MRD) in 31% of patients in complete clinical remission (CR) after 1 year of treatment.
  
  
  OBJECTIVE
  To confirm the frequency of MRD at 1 year and to determine its prognostic value for further relapse.
  
  
  METHODS
  Patients with T1-, T2- or T4-stage MF were prospectively included in this multicentre study. At diagnosis, clinical lesions and healthy skin were biopsied. After 1 year of topical treatment, previously involved skin of patients in CR was biopsied for histology and analysis of TCR-γ gene rearrangement. The results were compared with the clinical status each year for 4 years.
  
  
  RESULTS
  We included 214 patients, 133 at T1, 78 at T2 and three at T4 stage. At diagnosis, 126 of 204 cases (61·8%) showed TCR clonality in lesional skin. After 1 year, 83 of 178 patients (46·6%) still being followed up were in CR and 13 of 63 (21%) showed MRD. At 4 years, 55 of 109 patients (50·5%) still being followed up were in CR and 44 of 109 (40·4%) were in T1 stage. MRD did not affect clinical status at 4 years (CR vs. T1/T2, P = 1·0; positive predictive value 36·4%; negative predictive value 67·6%).
  
  
  CONCLUSIONS
  T-cell clonality at diagnosis and MRD at 1 year are not prognostic factors of clinical status at 4 years.
authors.affiliation: Dermatology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.|Dermatology Department, AP-HP, and INSERM U976 Saint-Louis Hospital, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Hurabielle
authors.affiliation: Dermatology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.|Cutaneous Lymphoma French Study Group (GFELC), Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Ingen-Housz-Oro
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Pathology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
authors.forename: N
authors.initials: N
authors.lastname: Ortonne
authors.affiliation: Laboratory of Haematology, Hôpital Robert Debré, Reims, France.
authors.forename: P
authors.initials: P
authors.lastname: Cornillet-Lefèbvre
authors.affiliation: Biological Immunology and Haematology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Merah
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHU - Hôpital Estaing, Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: D'Incan
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, Rouen University Hospital, INSERM U905, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University, Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Joly
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, AP-HP, Cochin Hospital, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Franck
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHR Orléans, Orléans, France.
authors.forename: E
authors.initials: E
authors.lastname: Estève
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, AP-HP, Bichat Hospital, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Maubec
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, Hôpital Robert Debré and EA 7319, Université de Reims Champagne-Ardenne, Reims, France.
authors.forename: F
authors.initials: F
authors.lastname: Grange
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHRU de Tours, Tours, INSERM U930, Université François Rabelais de Tours, Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Machet
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, AP-HP, Avicenne Hospital, Bobigny, France.
authors.forename: L
authors.initials: L
authors.lastname: Laroche
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, AP-HP, Pitié Salpêtrière, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Barete
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHU Dijon, Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Dalac
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHRU Lille, Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Mortier
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHU Mulhouse, Mulhouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Michel
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology Department, CHU Nantes, Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Quereux
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Dermatology and Oncology Department, EA 4340, University of Versailles-SQY, CHU A Paré, Boulogne-Billancourt, France.
authors.forename: P
authors.initials: P
authors.lastname: Saiag
authors.affiliation: Dermatology Department, AP-HP, and INSERM U976 Saint-Louis Hospital, Paris, France.|Cutaneous Lymphoma French Study Group (GFELC), Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Ram-Wolff
authors.affiliation: Haematology Department, Rouen University Hospital, Rouen, France.
authors.forename: B
authors.initials: B
authors.lastname: Lenormand
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Pathology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
authors.forename: J
authors.initials: J
authors.lastname: Wechsler
authors.affiliation: Clinical Research Centre, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
authors.forename: S
authors.initials: S
authors.lastname: Bastuji-Garin
authors.affiliation: Dermatology Department, AP-HP, and INSERM U976 Saint-Louis Hospital, Paris, France.|Cutaneous Lymphoma French Study Group (GFELC), Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bagot
authors.affiliation: Cutaneous Lymphoma French Study Group (GFELC), Paris, France.|Biological Immunology and Haematology Department, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
authors.forename: M H
authors.initials: MH
authors.lastname: Delfau-Larue
mesh_terms: D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002999:Clone Cells; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy* / Q000235:genetics; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D018365:Neoplasm, Residual / Q000235:genetics*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000235:genetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones