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Prepublished online as a Blood First Edition Paper on January 9, 2003; DOI 10.1182/blood-2002-05-1597.

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2002-05-1597v1
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Submitted May 31, 2002
Accepted December 31, 1969

Gamma delta ({gamma}{delta}) T-cell phenotype is associated with significantly decreased survival in cutaneous T-cell lymphoma

Jorge R Toro*, David J Liewehr, Nina Pabby, Lynn Sorbara, Mark Raffeld, Seth M Steinberg, and Elaine S Jaffe

National Cancer Institute, National Institutes of Health, Rockville, MD, USA

* Corresponding author; email: torojo{at}exchange.nih.gov.

BACKGROUND: The importance of {alpha}{beta} vs. {gamma}{delta} T-cell subset antigen expression in the classification of peripheral T-cell lymphomas is still unclear. The objective of this study was to investigate the prognostic value of TCRd1 expression in cutaneous T-cell lymphoma as related to other clinical and pathological features. METHODS: TCR{delta}1 cellular expression was assessed in skin biopsy specimens of 104 individuals with cutaneous T-cell lymphoma by immunohistochemistry. Both univariate (Kaplan-Meier) and multivariate (Cox regression) analyses were conducted to determine which variables (T-cell subtype, hemophagocytosis, histologic profile, age, sex, and adenopathy) were significantly associated with survival. RESULTS: Univariate analysis indicated that there was a statistically significant difference in survival between the patients with {alpha}{beta} cutaneous T-cell lymphoma and patients with {gamma}{delta} cutaneous T-cell lymphoma (p<0.0001). There was also a statistically significant decrease in survival among patients who had subcutaneous involvement compared with patients who had epidermotropic and/or dermal involvement (p<0.0001). A Cox model analysis was also done to evaluate factors simultaneously, and prognostic factors considered in the Cox analysis included: T-cell type, histologic profile, and sex. This analysis indicated that TCR{delta}1 expression was the factor that was most closely associated with decreased survival (P<0.0001). Among those patients with cutaneous {gamma}{delta} T-cell lymphoma (n=33), there was a trend for decreased survival for patients who had histological evidence of subcutaneous fat involvement in comparison to patients who had epidermotropic or dermal patters of infiltration (P=0.067). No other prognostic factors were identified as having a notable association with outcome in this subgroup. CONCLUSION: TCR{delta}1 expression in cutaneous lymphomas is an independent prognostic factor associated with decreased survival.


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