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Blood, 15 September 2002, Vol. 100, No. 6, pp. 2168-2174

IMMUNOBIOLOGY

A prospective study on the evolution of the T-cell repertoire in patients with Sézary syndrome treated by extracorporeal photopheresis

Saskia Ingen-Housz-Oro, Annette Bussel, Béatrice Flageul, Laurence Michel, Louis Dubertret, Philippe Kourilsky, Gabriel Gachelin, Hervé Bachelez, and Philippe Musette

From the Institut de Recherche sur la Peau, Institut National de la Santé et de la Recherche Médicale (INSERM) U532, Hôpital Saint-Louis, Paris, France; Institut Pasteur, Unité de Biologie Moléculaire du Gène, INSERM U277, Département d'Immunologie, Paris; Unité de therapie cellulaire et de clinique transfusionelle, Hôpital Saint-Louis, Paris, France.

Sézary syndrome is a leukemic form of epidermotropic cutaneous T-cell lymphoma related to the malignant proliferation of clonal CD4+ T cells. Extracorporeal photochemotherapy may induce a transient improvement of the clinical signs, but its efficiency is discussed. To investigate the frequency of the T-cell clone in the peripheral blood of patients with Sézary syndrome and to monitor its evolution in patients treated using extracorporeal photopheresis or chemotherapy, we used the immunoscope technique. In one patient, we observed a decrease of the relative frequency of the clone from 15.6% to 0%, paralleling a complete remission of the clinical disease and a disappearance of the circulating Sézary cells. In the other cases, the evolution of the relative frequency paralleled the initial improvement of the clinical status and the absence of long-term efficiency in patients treated with extracorporeal photopheresis or chemotherapy. We observed a quick-acting direct cytotoxicity of the association 8MOP + UVA on the T-cell clone. The immunoscope technique appears to be an efficient tool to appreciate the amount of tumoral cells and to monitor the evolution of the clonal component in the Sézary syndrome.

© 2002 by The American Society of Hematology.
 

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  Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020