Abstract
We retrospectively analyzed the clinicopathological correlation and prognostic value of cell surface antigens expressed by peripheral blood mononuclear cells in patients with mycosis fungoides (MF). 121 consecutive MF patients were included in this study. All patients had peripheral blood flow cytometry as part of their first visit. TNMB and histopathological staging of the cases were retrospectively performed in accordance with International Society for Cutaneous Lymphomas/European Organization of Research and Treatment of Cancer (ISCL/EORTC) criteria at the time of flow cytometry sampling. To determine prognostic value of cell surface antigens, cases were divided into two groups as stable and progressive disease. 17 flow cytometric analyses of 17 parapsoriasis (PP) and 11 analyses of 11 benign erythrodermic patients were included as control groups. Fluorescent labeled monoclonal antibodies were used to detect cell surface antigens: T cells (CD3+, CD4+, CD8+, TCRαβ +, TCRγδ +, CD7+, CD4+CD7+, CD4+CD7−, and CD71+), B cells (HLA-DR+, CD19+, and HLA-DR+CD19+), NKT cells (CD3+CD16+CD56+), and NK cells (CD3−CD16+CD56+). The mean value of all cell surface antigens was not statistically significant between parapsoriasis and MF groups. Along with an increase in cases of MF stage statistically significant difference was found between the mean values of cell surface antigens. Flow cytometric analysis of peripheral blood cell surface antigens in patients with mycosis fungoides may contribute to predicting disease stage and progression.
Highlights
Mycosis fungoides is the most common variant of primary cutaneous T cell lymphomas
Detection of T cell abnormalities by flow cytometry is increasing in use as an effective and a sensitive method in mycosis fungoides (MF) patients [4]
The importance of peripheral blood flow cytometry studies is highlighted by the ISCL/EORTC recommendations for diagnosis that include one or more of the following phenotypical abnormalities demonstrated by flow cytometry including peripheral blood CD4+/CD8+ rate being above 10, abnormal expression of pan-T cell markers including CD2+, CD3+, CD4+ antigens, and CD7
Summary
Mycosis fungoides is the most common variant of primary cutaneous T cell lymphomas. Most of MF patients first present with long-standing reactive inflammatory dermatoses such as PP en plaque so-called premycotic eruptions [1]. Flow cytometric analysis of the cell surface antigens, expressed by peripheral blood cells, is widely used in the diagnosis and management of hematologic malignancies; it has not been used routinely in the evaluation of MF patients. Neoplastic T cells frequently have an altered level of expression of various surface T cell markers compared with normal T cells. These differences are sufficient to distinguish normal T cells from neoplastic T cells in the same population [3]. Peripheral blood flow cytometry can detect aberrant T cell populations even when there is no lymphocytosis or elevated total white blood cell count. The importance of peripheral blood flow cytometry studies is highlighted by the ISCL/EORTC recommendations for diagnosis that include one or more of the following phenotypical abnormalities demonstrated by flow cytometry including peripheral blood CD4+/CD8+ rate being above 10, abnormal expression of pan-T cell markers including CD2+, CD3+, CD4+ antigens, and CD7
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