Prognosis Of Mycosis Fungoides Research Articles

Importance of the C-Reactive Protein to Albumin Ratio in the Diagnosis and Prognosis of Mycosis Fungoides.

The C-reactive protein to albumin ratio (CAR) lately has demonstrated as a prognostic factor and an indicator of disease activity, severity and prognosis in solid organ malignancies and inflammatory diseases. However, the effects of CAR have not been investigated in mycosis fungoides (MF) patients yet. This study aimed to determine the potential role of CAR as a diagnostic and a prognostic indicator in MF. We retrospectively investigated the electronic medical records of 97 patients with MF admitted to the Dermatology Clinic of Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital between January 2014 and December 2020. In total, 60 patients with MF were enrolled in the study. CAR was evaluated, patient and control group. Also, the other clinicopathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and sedimentation levels were evaluated. The median value of CAR was 0.85 (0.10-7.51) in the patient group, whereas it was 0.39 (0.0-1.11) in the control group (P < 0.001). Patients with disease progression (N = 16, 13M, 3 F) had a median value of CAR 0.84 (0.10-7.51) and the median value of CAR (N = 44) was 0.86 (0.12-4.57) in the group of patients with stable disease. The CAR value had no prognostic significance (P > 0.05). There is no association between the CAR and progression in the stage in MF patients. But the CAR is significantly higher in patients with MF than in the control group. The CAR can be a guide for us in cases where we have difficulty in diagnosing.

The Battle of Cutaneous T Cell Lymphomas: Mycosis Fungoides Vs. Sezary Syndrome

Introduction: Mycosis Fungoides (MF) &amp; Sezary Syndrome (SS) are two distinct extra-nodal Cutaneous T Cell Lymphomas (CTCL), which are a subtype of Non-Hodgkin's Lymphoma (NHL). Although belonging to the same entity, its presentation varies drastically. Early stage of MF is limited to the skin and whereas advanced-stage disease can involve lymph nodes, blood, &amp; visceral organs, whereas SS involves the blood, lymph nodes, and skin. The aim of this retrospective analysis is to study the variance in the epidemiology and prognosis of MF and SS. Method: The data was collected from Surveillance, Epidemiology and End Result database Research Plus Data, 17 Registries, Nov 2022 Sub (2000-2020). We extracted Mycosis Fungoides and Sezary Syndrome cases diagnosed after 20 years of age, with Lymphoid neoplasm recode 2(b)2.1.1 and 2(b)2.1.2. The analysis was stratified based on age, sex, racial incidence rates, &amp; survival curves based were compared, using the Log-rank test (GraphPad Prism). Results: 8853 cases of MF were identified between 2000-2020. The median age of diagnosis was 60 years. Of the affected individuals, 57.59% were males and 42.40% were females. The incidence of MF, per 1,000,000 population, in 2000 was 6.1 &amp; 6.05 in 2020. 62.45% were whites, 13.75% were blacks, 6.98% were Asians/Pacific Islanders, 0.42% were American Indians/Alaskan Natives, &amp; 11.64% were Hispanics. 5.2% of patients had localized disease, 8.38% patients had regionall disease, &amp; 1.34% had the evidence of distant metastasis. vs. 307 cases of SS were identified between 2000-2020. The median age of diagnosis was 71 years. Of the affected individuals, 56.35% were males and 43.64 were females. The incidence rate of SS, per 1,000,000 population, in 2000 was 0.17 &amp; 0.28 in 2020. 69.70% were whites, 14.00% were blacks, 2.28% were Asians/Pacific Islanders, 0.65% were American Indians/Alaskan Natives, &amp; 12.70% were Hispanics. 46.24% of patients had localized disease, 38.11% patients had regional disease, &amp; 16.61% had the evidence of distant metastasis. Survival analyses were compared for the general population &amp; further stratified based on races, between MF &amp; SS. The median of survival (mOS) was 238 months for MF &amp; 39 months for SS ( p&amp;lt;0.0001, Hazard Ratio (HR) 0.2215, Confidence Interval (CI) 0.1649 to 0.2975.) Conclusion: When the subtypes of CTCLs, MF &amp; SS, were compared, prevalence of MF was significantly more than SS. Incidence of MF somewhat stayed the same in 20 years vs SS showed an uptrend. Median age for diagnosis was higher SS (71 years) vs. SS(60 years). Both showed a strong predilection towards males. The most commonly affected race for both, was seen in Whites &amp; the least was for American Indians/Alaskan Natives. Survival for MF(238 months) was significantly higher than SS (39 months). Although rarer of the two CTCL, SS has a poorer prognosis. With this retrospective study, our aim was to understand the epidemiology of the two CTCLs, as with the newer treatment options for these diseases like Romidepsin and Brentuximab Vedotin, it would be interesting to do a follow-up study on the epidemiological variability &amp; survival, for these rare hematological malignancies.

Clinical characteristics, initial treatment, and prognosis of mycosis fungoides and Sézary syndrome: A retrospective, single-center study at the Centre Hospitalier Universitaire of Quebec

Clinical characteristics, initial treatment, and prognosis of mycosis fungoides and Sézary syndrome: A retrospective, single-center study at the Centre Hospitalier Universitaire of Quebec

The Role of microRNA in Pathogenesis, Diagnosis, Different Variants, Treatment and Prognosis of Mycosis Fungoides.

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), accounting for approximately 50% of all CTCLs. Although various molecular changes in MF have been described in existing studies, no obvious disease-specific changes have been found thus far. microRNAs (miRs) are short, noncoding RNA molecules that play roles in the post-transcriptional regulation of oncogenes and tumor suppressor genes in various diseases. Recently, there has been rapidly expanding experimental evidence for the role of miRs in the progression, early diagnosis, prognosis prediction for MF. Efforts to improve early diagnosis and develop personalized therapy options have become more important in recent years. Here, we provide an overview and update of recent advances regarding miRs associated with MF. Furthermore, we provide insights into future opportunities for miR-based therapies.

Bio-P-02 - Genetic expression profile in the prognosis of mycosis fungoides

We present a historic cohort study with 57 patients diagnosed with mycosis fungoides in early stages during the years 1999 to 2002. Our group performed a cDNA microarray on the diagnosis skin biopsies samples with the CNIO (oncologic investigation national center of Spain) Onco-Chip. This chip includes 6386 cancer-related clones. Since the samples were processed in two deferent years the initial set of 57 patients was divided in two groups of 29 and 28 patients due to the heterogeneity of the sample array results. The patients had a medium of 14 years of follow-up and were divided in two groups: progression (development of tumor, nodes, erythroderma, blood involvement or metastasis) and no progression. And we performed volcano pot analysis and GSEA to determine whether there are different genes expressions at diagnosis that determine prognosis. Several pathways were up and down regulated differently in patients progressing. We performed a GSEA analysis with the following results. Pathways related with progression: CXCR4 pathway (p=0.000) Normalized Enrichment Score (NES) 1.91 and FDR 0.027; genes: BCAR1, PXN, PIK3CA, PTK2, PIK3R1, PRKCA, HRAS, RAF1, CXCL12, PIK3C2G, GNB1. Other pathways with p<5% were: ERK5 pathway p=0.035, NES 1.15, FDR 0.92; genes: PIK3CA, PIK3R1, HRAS, RPS6KA1, SHC1. AKT pathway p=0.049, NES 1.52, FDR 0.70; genes: PIK3CA, PIK3R1, GHR, CASP9, YWHAH. Cytokine pathway p=0.034, NES 1.49, FDR 0.66; genes: SOCS6, SOD2, CCL2. PIK 3-CL1 pathway p=0.035, NES 1.39, FDR 0.63; genes: PIK3CA and PIK3CD INFAR1 pathway p=0.012, NES –1.51, FDR 1; genes: IFNAR1, JAK1, IFNAR2. P53 pathway p=0.032, NES –1.48, FDR 1; genes: MDM2, ABCB1, TP53. Pathways related with no progression: lymphocyte pathway p=0.000, FDR 0.31 NES –1.67; genes: ITGA, ITGB1, SELL, SELP. UV response pathway p=0.007, NES 1.62, FDR 0.40; genes: NTRK3, CCNE1, RAB27A, LYN, CEBPG, IL6ST, GAL, PSMC3, RRAD, ATF3, SOD2, BAK1, STIP1, GCH1, BMP2, PRKCD, RFC4, E2F2, IRF1, RASGRP1, BTG3, CDKN1C, ATP6V1F, CHKA, EIF5, POLE3, CDC5, UROD, CDC34, NR4A1, ENO2, JUNB, SLC6A8, DNAJB1, IGFB2, CDK2, PPIF, ABCB1, RXRB, PPT1, SPOP, KIT, MET, EIF5, FURIN. Other pathway with p<5% was: ERK pathway p=0.048, NES –1.48, FDR 0.93; genes: SRC, NGFB, HRAS; IGF1R, RPS6KA1, MYC, EGFR, RAF, SHC1, PDGFRA, GNB1, STAT3, NGFR, ITGB1, GNAS. We also performed a volcano pot study that showed overexpression of PPP1R3C a gene related with the mTOR pathway in the progression cases. Although our sample size was limited, we believe that pathways related with JAK/STAT, PIK/AKT/mTOR, MAPK, and cellular cycle can be differentially expressed in patients that have progression of the disease from the early stages of mycosis fungoides. Further studies are necessary to validate our results.

LB713 Proteomic identification of new diagnostic biomarkers of early-stage Cutaneous Mycosis Fungoides

Primary cutaneous T-cell lymphoma (CTCL) is responsible for two-thirds of cutaneous lymphoma cases. Mycosis fungoides (MF), the most common subtype of CTCL comprises approximately 60% of CTCLs. Due to the similar clinical features of MF and inflammatory diseases such as eczema and psoriasis2,3, early-stage MF can easily be misdiagnosed as chronic inflammatory dermatoses, posing a diagnostic challenge to the dermatologist. Early-stage MF is characterized by a favorable prognosis with long-term survival similar to or slightly lower than that of age-matched healthy people, with a 5-year survival between 88% and 100%. In contrast, advanced-stage MF shows aggressive progression, and the median survival time of patients with lymph node and visceral involvement is only 13 months. Therefore, it is important to achieve early diagnosis to improve prognosis, yet there are few specific biomarkers for the early diagnosis and prognosis of MF. In this study, we described the pathological features of MF during the early and advanced stages through proteomics technology, providing clues for the pathogenesis of MF as well as biomarkers for malignant tumors in the early stage. More importantly, diagnostic biomarkers of early-stage MF were identified by comparing the proteomic characteristics of early-stage MF and inflammatory diseases, with the goal of preventing delayed therapy due to misdiagnosis.

Lactate dehydrogenase, Beta-2 Microglobulin Levels and CD4/CD8 Lymphocyte Ratio in Patients with Mycosis Fungoides in Stage 1A

Objective: Mycosis fungoides is the most common type of primary cutaneous T-cell lymphomas. In this study, we aimed to investigate the biochemical parameters of beta-2 microglobulin, lactate dehydrogenase, CD4/CD8 lymphocyte ratio determined by flow cytometry, and T cell clonality in patients with MF and to correlate these parameters in stage 1A and other stages.&#x0D; Materials and Methods: A hundred sixty-one (87 Male, 74 Female) patients followed-up between January 1995 and January 2019 were retrospectively evaluated. Patients’ demographics, stage of the disease, peripheral lymph node and organ involvement, peripheral blood beta-2-microglobulin, lactate dehydrogenase levels, CD4/CD8 + lymphocyte ratio and presence of T cell clonality in biopsy samples were evaluated.&#x0D; Results: Median beta-2 microglobulin levels were 1608.5 ng/ml for stage 1A and 1970.5 ng/ml for other stages. Peripheral blood median CD4/CD8 lymphocte ratio was 1.60 for stage 1A and 1.85 for other stages. We found statistically significant difference between two groups in terms of beta-2 microglobulin levels and peripheral blood median CD4/CD8 lymphocte ratio (p=0.001, p=0.04). No statistically significant difference was found between two groups in terms of lactate dehydrogenase levels and T-cell clonality (p=0.234, p=0.525).&#x0D; Conclusion: Our study supports that high peripheral blood beta-2 microglobulin level and CD4/CD8 lymphocyte ratio at the time of diagnosis may imply advanced stage and poor prognosis in Mycosis Fungoides.

Expression of CCR3 and CCR4 Suggests a Poor Prognosis in Mycosis Fungoides and Sézary Syndrome.

Tumor cells in cutaneous T-cell lymphoma express limited numbers of chemokine receptors. We investigated the expression patterns of CXCR3, CCR3, CCR4 and CCR10 in mycosis fungoides, Sézary syndrome, lym-phomatoid papulosis and anaplastic large cell lymphoma in 121 skin biopsy samples. CXCR3 was expressed in 86% of mycosis fungoides cases but in no anaplastic large cell lymphoma cases. CCR3 was expressed in 73% of cases of CD30+ lymphoproliferative disorders such as lymphomatoid papulosis and anaplastic large cell lymphoma. Mycosis fungoides/Sézary syndrome patients with high CCR3 or CCR4 expression had a poorer survival prognosis than mycosis fungoides/Sézary syndrome patients whose tumor cells did not express these receptors. CCR10 was expressed in 50% of mycosis fungoides/Sézary syndrome cases and in 13% of cases with CD30+ lym-phoproliferative disorders. These results suggest that differential patterns of CXCR3, CCR3, CCR4 and CCR10 expression are useful for the diagnosis of cutaneous T-cell lymphoma. Moreover, expression of CCR3 or CCR4 suggests a poor prognosis in mycosis fungoides/Sézary syndrome.

Roles of microRNAs in mycosis fungoides

Mycosis fungoides (MF) , a kind of primary cutaneous T cell lymphoma (CTCL) with various manifestations, is easy to misdiagnose. MicroRNAs (miRNAs) are a group of small non-coding RNA molecules of about 22 nucleotides in length, and participate in many biological processes, such as cell differentiation, proliferation, metabolism and apoptosis. Dysfunction of miRNAs is involved in the development of neoplasms. Studies have shown that some miRNAs play important roles in the pathogenesis, auxiliary diagnosis and prediction of prognosis of MF, and have potential value in the treatment of MF. For example, miR-155, miR-22 and miR-150 can promote the development of MF, while miR-233 and miR-200c can inhibit it. A group of miRNAs, including miR-155, miR-203 and miR-205, are considered to be helpful in distinguishing CTCL from benign skin diseases. Key words: MicroRNAs; Lymphoma, T-cell; Diagnosis; Therapeutic uses; Mycosis fungoides

Mycosis fungoides: association of KIR ligands and HLA-DQB1*05 with bad prognosis of the disease.

Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. We previously reported that the prognosis of MF patients is not only related on clinical variables but it is also associated with peculiar HLA alleles. Until today, the association of HLA ligands for KIR with the prognosis of the disease has not yet been analysed. We investigated the frequency of HLA ligands for killer cell Immunoglobulin-like receptors (KIRs) in MF patients, evaluating if the presence of particular HLA alleles that are ligands for KIR may have prognostic value. The study includes 46 Caucasian MF patients that, between 1993 and 1997, underwent HLA genomic typing. All patients were diagnosed and followed up from 1977 to 2012 (mean follow-up of 11 years). MF patients have been divided into two groups (long survivors and dead patients). We noticed that the HLA-Bw6/Bw6 specificity increased among the group of seven dead patients compared to the group of 39 long survivors (71.4% vs. 41.0%, P = ns, OR = 3.59), while in the long survivors group the HLA- Bw4/Bw4 specificity increased when compared to dead patients (23.0% vs. 0%, P = ns). Moreover, we observed that six of the seven dead patients had HLA-DQB1*05; the phenotypic frequency of this HLA allele, in dead and long survivors patients, was 85.7% and 23.0% respectively (P = 0.004; OR = 20). Our observations suggest that the presence of the HLA-DQB1*05 alleles characterizes the patients with the poorest prognosis in MF. In addition, absence of the KIR-ligand epitope HLA-B Bw4 showed a trend of being more prominent in MF patients with the poorest prognosis.

Vascular endothelial growth factor A (VEGFA) expression in mycosis fungoides.

High levels of vascular endothelial growth factor A (VEGFA) seem to herald a worse prognosis in mycosis fungoides (MF). In this study, we aimed to characterize more clearly VEGFA gene and protein expression in MF. First, we compared VEGFA mRNA levels in MF and in normal T lymphocyte samples; significantly higher VEGFA levels were found in MF. We then studied VEGFA expression in different normal T cell subsets, focusing on CD4(+) , CD8(+) , resting and activated T lymphocytes. We applied the gene signatures of the normal T cell subsets to MF samples and found that activated T lymphocytes represented the closest normal counterpart of the tumour. However, VEGFA mRNA levels were significantly higher in MF than in activated normal T cells, suggesting that VEGFA overexpression in MF represents an attribute acquired during neoplastic transformation: no significant VEGFA expression differences were recorded between early and advanced stages. Gene expression profile results were supported by immunohistochemistry in routine sections from 27 MF cases. For the first time, we demonstrate VEGFA expression in MF cells, suggesting that the VEGF pathway may be implicated in MF pathogenesis and can represent a novel therapeutic target.

Hypopigmented Mycosis Fungoides versus Mycosis Fungoides with Concomitant Hypopigmented Lesions: Same Disease or Different Variants of Mycosis Fungoides?

Background: Hypopigmented mycosis fungoides (HMF) is a rare subtype of mycosis fungoides (MF). We compared patients with exclusive hypopigmented lesions with a group of MF patients with concomitant different lesions. Methods: 20 patients with HMF only and 14 patients with hypopigmented lesions concomitant with other types of lesions (mixed MF, MMF) were selected. Clinical-epidemiological analysis as well as histological and immunohistochemical studies were performed. Results: HMF and MMF preserve some similarities, like predilection for dark-skinned persons and slow progression, but they also present differences: the exclusive variant is associated with early onset and a clear CD8+ immunophenotype, whereas MMF patients tend to present a predominance of CD4+ cell infiltrates. Histological analysis revealed similar findings; relapsing courses were common. Conclusion: Whether patients are suffering from exclusive HMF or MMF, the presence of hypopigmented lesions can be considered a marker of good prognosis in MF, since both groups presented similar data, such as staging and disease duration.

The influence of the coexpression of CD4 and CD8 in cutaneous lesions on prognosis of mycosis fungoides: a preliminary study.

Background. Although techniques of immunophenotyping have been successful in characterizing the cells in the cutaneous infiltrates of mycosis fungoides little evidence suggests that variations in the phenotypic characterization correlate with prognosis. Objectives. In a preliminary prospective, single-centre, study we correlated the T-cell phenotype in cutaneous biopsies with the progression of the disease to determine whether the coexpression of CD4 and CD8 has an impact on prognosis. Methods. Skin biopsy specimens from 30 newly diagnosed patients were stained with immunoperoxidase techniques to determine their phenotypic characteristics. After a median followup of 42 months patients were divided into two groups with stable and progressive disease. Results. Eighteen patients had the conventional CD4+CD8− T-cell phenotype. Ten patients showed the coexpression of CD4 and CD8 and had a slightly lower rate of progressive disease. Conclusions. The coexpression of CD4 and CD8 in cutaneous lesions is not rare and is associated with a slightly lower rate of progressive disease. Since double positive CD4/CD8 phenotype is rarely reported in mycosis fungoides the presence on conventional immunophenotyping of both CD may be due to a “mixture” of neoplastic cells and inflammatory CD8+ tumor infiltrating lymphocytes. Immunohistochemical study combined with confocal microscopy could clarify this issue.

Mycosis Fungoides Misdiagnosed As Squamous Cell Carcinoma

Mycosis Fungoides Misdiagnosed As Squamous Cell Carcinoma

Mycosis fungoides in children and adolescents

Mycosis fungoides (MF) is a low-grade lymphoproliferative disorder that is histologically characterized by an epidermotropic proliferation of small or medium-sized atypical T lymphocytes with cerebriform nuclei and is primarily a disease of the elderly. It is rare in children and adolescents; in large series of MF published in the literature, only a small percentage of patients were observed to have onset of MF below adolescence. It was believed that a younger age of onset of MF may herald a poorer prognosis. Recently, with improved knowledge of the basic nature of the disease and refined diagnostic facilities, a few series of MF among children and adolescence have appeared and have drawn more awareness to the behavior of MF in this age group. This review summarizes the clinicoepidemiological features, treatment and prognosis of MF among children and adolescents based on the current literature.

FOXP3 in Sequential Biopsies of Progressive Mycosis Fungoides

A recent report has suggested that the numbers of regulatory T cells correlate with stage of disease and prognosis in mycosis fungoides (MF). To evaluate the role of FOXP3+ Tregs in different stages of MF, we investigated sequential biopsies in 14 patients with patch/plaque and subsequent tumor stage using FOXP3 antibody. Our data neither show a significant difference in the percentage of FOXP3+ cells between patch/plaque and tumor stage biopsies of MF nor demonstrate a predictable shift of Tregs in the course of disease progression. Additionally, we could observe FOXP3-expressing neoplastic cells in 4 patch/plaque stage biopsies, where they represented almost 100% of the epidermotropic infiltrate. Only in one of these patients, FOXP3+ cells could also be detected in the tumor stage biopsy, indicating that FOXP3 expression can be acquired or lost during the course of the disease, comparable to other phenotypic markers.

FOXP3 Can Predict Disease Progression and Risk of Transformation in Uniformly Treated Patients with Mycosis Fungoides

Abstract 5182 Background:Mycosis fungoides (MF) is a heterogeneous lymphoid neoplasm with a variable clinical course. In early stages MF often runs an indolent course. A small but significant part of these patients develop an aggressive course frequently associated with inferior survival. No consistent biological markers are predictive of survival or risk of transformation (RT). Foxp3 belongs to a novel forkhead transcription factor essential for the development and regulation of regulatory T-cells (Treg). Recent studies have shown conflicting results when expression of Foxp3 was analyzed as a prognostic factor in MF. We hypothesized that Foxp3 could be an important marker in predicting for overall survival (OS), progression-free (PFS) survival and RT in MF patients managed by uniform treatment regimens. Methods:42 patients with newly diagnosed MF were retrieved form the record files. All patients were managed and treated at our institute. Complete follow-up and pathological material (paraffin blocks) was available for 35/42 patients. In all 35 cases the diagnostic biopsies were reviewed concurrently by an expert dermatopathologist and hematopathologist and diagnosis fully confirmed. The diagnostic biopsies were immunostained with CD3, CD4, CD7, CD8, CD30 and CD56 specific antibodies. Clonality for TCR gamma was performed for most of the cases in the study (85%). FOXP3 antibody (clone 221D/D3) that recognizes the Foxp3 in the nucleus (but does not cross react with other Foxp proteins) was utilized for studying the Foxp3 expression by the tumor cells and or peritumoral lymphocytes. 20 cases of reactive non-neoplastic dermal lesions including lichen planus, lupus and dermatitis were also immunostained for Foxp3 for comparison. Only high intensity nuclear staining was accepted as positive expression. The Foxp3 staining was further semi quantitatively estimated as no expression (0), 0–10% (1+), 10–50% (2+) and >50% (3+). Both the cell content and immuno-architectureal pattern were determined. Age, sex, clinical presentation, stage of disease was compared to Fox3 expression by chi-square and Fishers’s exact test. The Kaplan-Meyer method and log rank test were used to evaluate survival data. Results:34 of 35 (97%) patients were alive at 8 years. Tumor stage at the time of diagnosis as defined by ISCL-EORTC, 2008 was as follows: stage 1A (57%), 1B (25%), 2A (6%), 2B (6%), 3 (6%). 19/35 (54%) were female and 16/35 (46%) were male. The median age at diagnosis was 44.0 years (range 7–80 years). The median follow-up period was 37 months (range 12– 96 months). Foxp3 expression showed predominantly intraepidermal or basal localization of tumor cells. In most of the cases the epidermotropism and the nuclear atypia was helpful in easily discerning tumor cells from reactive non-neoplastic Tregs. Reactive dermal lesions served as an excellent control in that the distribution of Tregs in these lesions was predominantly dermal and rarely basal. Overall 28/35 (80%) and 7/35 (20%) cases were positive and negative for Foxp3 respectively. There was no significant correlation between disease pattern, clinical presentation, stage, age or sex and marker expression. In the Foxp3 positive patients 17/28(61%) showed disease progression whereas 11/28 (39%) were free of disease at last follow-up (FU period 12–96 months) (p=0.05, Fisher’s exact test). 13/28 (46%) Foxp3+ patients were found to have relapse of disease after initial response compared to only 2/7 (28.5%) patients, who relapsed but lacked Foxp3 expression (p=0.242, Fisher’s exact test). Comparing disease progression and aggressiveness as evidenced by lymph node metastasis and transformation to Sezary syndrome: only Foxp3 positive cases (4 versus 0) had evidence of disease progression (3 lymph node metastasis alone and one Sezary syndrome) thus indicating increased RT. One patient who died of widespread disease showed >30% Foxp3 expression in the neoplastic lymphoid cells. Conclusions:Specific biological markers for outcome and prognosis in MF remain elusive. A regulatory T-cell (Treg) phenotype defines a subset of MF patients who might carry a different prognosis and might require more aggressive and or targeted therapy. More data on Foxp3 expression in cutaneous T-cell lymphomas and its clinical significance is needed. Disclosures:No relevant conflicts of interest to declare.

Phototherapy of mycosis fungoides

Among the primary cutaneous T-cell lymphomas, mycosis fungoides (MF) is the most common disease entity. Recently, an improved understanding of the pathology, clinical presentation, and prognosis of MF has lead to the development of new and practically useful classification and staging systems. In most patients, MF presents with patches and plaques and remains confined to the skin for years and decades, making it an ideal target for phototherapy. However, treatment schedules vary widely and this review describes the current knowledge about phototherapy of MF focusing mainly on narrow- and broadband UVB and 8-methoxypsoralen plus UVA, its indications, practical aspects, and clinical outcome. Review and summary of the pertinent literature. Since 1976, when the first report on phototherapy for MF was published, sufficient evidence has accumulated to make narrowband UVB and PUVA safe and effective treatment options for early stages of the disease. In refractory cases or more advanced stages, combination of phototherapy with systemic treatments including mainly interferons and retinoids might be valuable. Additional research is required to further define the optimal treatment schedules and the role of maintenance.

Application of DNA flow cytometry from paraffin‐embedded tissue to the diagnosis of mycosis fungoides

The distinction of mycosis fungoides from benign inflammatory lesions is sometimes difficult by conventional histological techniques. Aneuploidy, a feature often associated with malignant tumors, can be assessed even in tissue routinely processed in paraffin using the flow cytometric technique of Hedley and associates. In many tumor systems, there are significant diploid clones. We have evaluated the flow cytometric DNA ploidy of paraffin-embedded tissue in the diagnosis and prognosis of mycosis fungoides (MF). We studied 22 cases of MF and 10 control cases of inflammatory skin lesions with epidermal involvement. Aneuploidy was found in 27% of the MF cases, but in none of the controls (ED). Aneuploid features were seen in 23% of tissues from early stage disease. Aneuploidy did not correlate with atypia, epidermotropism, or number of mitoses. There was a trend towards showing adverse outcome in those patients with aneuploid lesions. The detection of aneuploidy might be helpful for early diagnosis of MF.