BACKGROUND: Because there are currently many effective therapies available for Sézary syndrome, close monitoring of disease progression is required in order for a clinician to know when to institute or change an intervention. It has been our clinical experience that changes in patients' CD4+CD26- T-cell populations of peripheral blood lymphocytes herald changes in their clinical status. OBJECTIVE: Our purpose was to evaluate whether a change in patients' CD4+CD26- population of T cells presages a change in their clinical status. We also sought to investigate the association between a change in T-cell populations that are CD4+CD7-, CD8+, CD56+, and the CD4+/CD8+ T-cell ratio and a change in the patient's clinical status. METHODS: We conducted a retrospective chart review analysis of 21 patients with Sézary syndrome who had flow cytometry, usually including levels of CD4+CD26-, CD4+CD7-, CD8+, CD56+, and CD4+/CD8+ ratios measured at two time periods, 12 weeks apart. RESULTS: We report two cases in which changes in patients' clinical status were preceded by several weeks by a change in their CD4+CD26- level. We report weak associations between a decreasing CD4+CD26- T-cell population, a decreasing CD4+CD7- population, an increasing CD56+ population, and an improving clinical status. We also report stronger associations between both a decreasing CD8+ population and an increasing CD4+/CD8+ ratio and a worsening clinical status. LIMITATIONS: The study was limited by the number of patients and the time period over which the study was conducted. In addition, varying configurations of CD4+CD26- T-cell populations were observed that may have limited the utility of this measurement. CONCLUSIONS: Flow cytometry assays of patients' blood and, in particular, measurement of the CD4+CD26- population of lymphocytes over time may be a valuable tool for monitoring patients with Sézary syndrome. There exist varying configurations of CD26 T lymphocytes that may cause differences in standards for what is considered positive and negative between observers. Further prospective analysis involving larger groups of patients is recommended.
BACKGROUND: Because there are currently many effective therapies available for Sézary syndrome, close monitoring of disease progression is required in order for a clinician to know when to institute or change an intervention. It has been our clinical experience that changes in patients' CD4+CD26- T-cell populations of peripheral blood lymphocytes herald changes in their clinical status. OBJECTIVE: Our purpose was to evaluate whether a change in patients' CD4+CD26- population of T cells presages a change in their clinical status. We also sought to investigate the association between a change in T-cell populations that are CD4+CD7-, CD8+, CD56+, and the CD4+/CD8+ T-cell ratio and a change in the patient's clinical status. METHODS: We conducted a retrospective chart review analysis of 21 patients with Sézary syndrome who had flow cytometry, usually including levels of CD4+CD26-, CD4+CD7-, CD8+, CD56+, and CD4+/CD8+ ratios measured at two time periods, 12 weeks apart. RESULTS: We report two cases in which changes in patients' clinical status were preceded by several weeks by a change in their CD4+CD26- level. We report weak associations between a decreasing CD4+CD26- T-cell population, a decreasing CD4+CD7- population, an increasing CD56+ population, and an improving clinical status. We also report stronger associations between both a decreasing CD8+ population and an increasing CD4+/CD8+ ratio and a worsening clinical status. LIMITATIONS: The study was limited by the number of patients and the time period over which the study was conducted. In addition, varying configurations of CD4+CD26- T-cell populations were observed that may have limited the utility of this measurement. CONCLUSIONS: Flow cytometry assays of patients' blood and, in particular, measurement of the CD4+CD26- population of lymphocytes over time may be a valuable tool for monitoring patients with Sézary syndrome. There exist varying configurations of CD26 T lymphocytes that may cause differences in standards for what is considered positive and negative between observers. Further prospective analysis involving larger groups of patients is recommended.
Authors: Maria Wysocka; Noor Dawany; Bernice Benoit; Andrew V Kossenkov; Andrea B Troxel; Joel M Gelfand; Michael Kelly Sell; Louise C Showe; Alain H Rook Journal: Leuk Lymphoma Date: 2011-10
Authors: Richard L Piekarz; Robin Frye; Maria Turner; John J Wright; Steven L Allen; Mark H Kirschbaum; Jasmine Zain; H Miles Prince; John P Leonard; Larisa J Geskin; Craig Reeder; David Joske; William D Figg; Erin R Gardner; Seth M Steinberg; Elaine S Jaffe; Maryalice Stetler-Stevenson; Stephen Lade; A Tito Fojo; Susan E Bates Journal: J Clin Oncol Date: 2009-10-13 Impact factor: 44.544
Authors: Maria Wysocka; Andrew V Kossenkov; Bernice M Benoit; Andrea B Troxel; Elisha Singer; Andras Schaffer; Brian Kim; Tzvete Dentchev; Satoshi Nagata; Tomoko Ise; Louise C Showe; Alain H Rook Journal: J Invest Dermatol Date: 2013-06-21 Impact factor: 8.551