1
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Ishitsuka K, Yasukawa T, Tsuji Y. Safety and effectiveness of mogamulizumab in relapsed or refractory CC chemokine receptor 4-positive peripheral T-cell lymphoma and relapsed or refractory cutaneous T-cell lymphoma: A post-marketing surveillance in Japan. Hematol Oncol 2024; 42:e3292. [PMID: 38847317 DOI: 10.1002/hon.3292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Mogamulizumab is a humanized antibody targeting CC chemokine receptor 4 (CCR4). This post-marketing surveillance was conducted in Japan as a regulatory requirement from 2014 to 2020 to ensure the safety and effectiveness of mogamulizumab in patients with relapsed or refractory (r/r) CCR4-positive peripheral T-cell lymphoma (PTCL) or r/r cutaneous T-cell lymphoma (CTCL). Safety and effectiveness data were collected for up to 31 weeks after treatment initiation. A total of 142 patients were registered; safety was evaluated in 136 patients. The median number of doses was 8.0 (range, 1-18). The main reasons for treatment termination were insufficient response (22.1%) and adverse events (13.2%). The frequency of any grade adverse drug reaction was 57.4%, including skin disorders (26.5%), infections and immune system disorders (16.2%), and infusion-related reactions (13.2%). Graft-versus-host disease, grade 2, developed in one of two patients who underwent allogeneic-hematopoietic stem cell transplantation after receiving mogamulizumab. Effectiveness was evaluated in 131 patients (103 with PTCL; 28 with CTCL). The best overall response rate was 45.8% (PTCL, 47.6%; CTCL, 39.3%). At week 31, the survival rate was 69.0% (95% confidence interval, 59.8%-76.5%) [PTCL, 64.4% (54.0%-73.0%); CTCL, 90.5% (67.0%-97.5%)]. Safety and effectiveness were comparable between patients <70 and ≥ 70 years old and between those with relapsed and refractory disease. The safety and effectiveness of mogamulizumab for PTCL and CTCL in the real world were comparable with the data reported in previous clinical trials. Clinical Trial Registration.
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MESH Headings
- Humans
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/administration & dosage
- Male
- Female
- Aged
- Middle Aged
- Receptors, CCR4/antagonists & inhibitors
- Adult
- Japan
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Peripheral/drug therapy
- Aged, 80 and over
- Product Surveillance, Postmarketing
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Young Adult
- Drug Resistance, Neoplasm
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Affiliation(s)
- Kenji Ishitsuka
- Division of Hematology and Rheumatology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | - Yukie Tsuji
- Pharmacovigilance Division, Kyowa Kirin Co., Ltd., Tokyo, Japan
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2
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Cherfan C, Chebly A, Rezvani HR, Beylot-Barry M, Chevret E. Delving into the Metabolism of Sézary Cells: A Brief Review. Genes (Basel) 2024; 15:635. [PMID: 38790264 PMCID: PMC11121102 DOI: 10.3390/genes15050635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Primary cutaneous lymphomas (PCLs) are a heterogeneous group of lymphoproliferative disorders caused by the accumulation of neoplastic T or B lymphocytes in the skin. Sézary syndrome (SS) is an aggressive and rare form of cutaneous T cell lymphoma (CTCL) characterized by an erythroderma and the presence of atypical cerebriform T cells named Sézary cells in skin and blood. Most of the available treatments for SS are not curative, which means there is an urgent need for the development of novel efficient therapies. Recently, targeting cancer metabolism has emerged as a promising strategy for cancer therapy. This is due to the accumulating evidence that metabolic reprogramming highly contributes to tumor progression. Genes play a pivotal role in regulating metabolic processes, and alterations in these genes can disrupt the delicate balance of metabolic pathways, potentially contributing to cancer development. In this review, we discuss the importance of targeting energy metabolism in tumors and the currently available data on the metabolism of Sézary cells, paving the way for potential new therapeutic approaches aiming to improve clinical outcomes for patients suffering from SS.
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Affiliation(s)
- Carel Cherfan
- BRIC, BoRdeaux Institute of onCology, UMR 1312, Inserm, Université de Bordeaux, 33000 Bordeaux, France; (C.C.); (H.R.R.); (M.B.-B.)
| | - Alain Chebly
- Center Jacques Loiselet for Medical Genetics and Genomics (CGGM), Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon;
| | - Hamid Reza Rezvani
- BRIC, BoRdeaux Institute of onCology, UMR 1312, Inserm, Université de Bordeaux, 33000 Bordeaux, France; (C.C.); (H.R.R.); (M.B.-B.)
| | - Marie Beylot-Barry
- BRIC, BoRdeaux Institute of onCology, UMR 1312, Inserm, Université de Bordeaux, 33000 Bordeaux, France; (C.C.); (H.R.R.); (M.B.-B.)
- Dermatology Department, Centre Hospitalier Universitaire de Bordeaux, 33075 Bordeaux, France
| | - Edith Chevret
- BRIC, BoRdeaux Institute of onCology, UMR 1312, Inserm, Université de Bordeaux, 33000 Bordeaux, France; (C.C.); (H.R.R.); (M.B.-B.)
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3
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Sharma V, Bagrodia V. Advanced Cutaneous Peripheral T-cell Lymphoma-Not Otherwise Specified with Extensive Ulceronecrotic Dyschromic Plaques and Poor Outcome. Turk J Haematol 2024; 41:43-44. [PMID: 37431280 PMCID: PMC10918397 DOI: 10.4274/tjh.galenos.2023.2023.0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023] Open
Affiliation(s)
- Vishnu Sharma
- Medicine Department at SMS Medical College, Jaipur, India
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4
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Vahabi SM, Bahramian S, Esmaeili F, Danaei B, Kalantari Y, Fazeli P, Sadeghi S, Hajizadeh N, Assaf C, Etesami I. JAK Inhibitors in Cutaneous T-Cell Lymphoma: Friend or Foe? A Systematic Review of the Published Literature. Cancers (Basel) 2024; 16:861. [PMID: 38473222 DOI: 10.3390/cancers16050861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/17/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of lymphoid neoplasms with high relapse rates and no curative treatment other than allogeneic stem cell transplantation (allo-SCT). CTCL is significantly influenced by disruption of JAK/STAT signaling. Therefore, Janus kinase (JAK) inhibitors may be promising for CTCL treatment. This study is a systematic review aiming to investigate the role of JAK inhibitors in the treatment of CTCL, including their efficacy and safety. Out of 438 initially searched articles, we present 13 eligible ones. The overall response rate (ORR) in the treatment with JAK inhibitors in clinical trials was 11-35%, although different subtypes of CTCL showed different ORRs. Mycosis fungoides showed an ORR of 14-45%, while subcutaneous-panniculitis-like T-cell lymphoma (SPTCL) displayed an ORR ranging from 75% to 100%. Five cases were reported having a relapse/incident of CTCL after using JAK inhibitors; of these, three cases were de novo CTCLs in patients under treatment with a JAK inhibitor due to refractory arthritis, and two cases were relapsed disease after graft-versus-host disease treatment following allo-SCT. In conclusion, using JAK inhibitors for CTCL treatment seems promising with acceptable side effects, especially in patients with SPTCL. Some biomarkers, like pS6, showed an association with better responses. Caution should be taken when treating patients with an underlying autoimmune disease and prior immunosuppression.
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Affiliation(s)
| | - Saeed Bahramian
- School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Farzad Esmaeili
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Bardia Danaei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Yasamin Kalantari
- School of Medicine, Tehran University of Medical Sciences, Tehran 1461884513, Iran
| | | | - Sara Sadeghi
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Nima Hajizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Chalid Assaf
- Department of Dermatology and Venerology, Helios Klinikum Krefeld, 47805 Krefeld, Germany
- Institute for Molecular Medicine, Medical School Hamburg, 20457 Hamburg, Germany
| | - Ifa Etesami
- Departments of Dermatology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran 1983969411, Iran
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5
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Preston JD, Jansen CS, Kosaraju S, Niyogusaba T, Zhuang TZ, Iwamoto SW, Hutto SK, Lechowicz MJ, Allen PB. Cutaneous T-cell lymphoma with CNS involvement: a case series and review of the literature. CNS Oncol 2023; 12:CNS105. [PMID: 37877303 PMCID: PMC10701703 DOI: 10.2217/cns-2023-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a rare hematologic malignancy that traditionally presents with cutaneous lesions, though metastases are not uncommon in progressive disease. We describe four cases of CTCL with central nervous system (CNS) involvement, detailing the history, pathological characteristics, treatment response, and progression. Median time from initial diagnosis to CNS metastasis was ∼5.4 years (range 3.4-15.5 years) and survival after metastasis was ∼160 days (range 19 days-4.4 years). No patients achieved long-term (>5 years) survival, though some displayed varying degrees of remission following CNS-directed therapy. We conclude that clinicians must be attentive to the development of CNS metastases in patients with CTCL. The growing body of literature on such cases will inform evolving therapeutic guidelines on this rare CTCL complication.
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Affiliation(s)
- Joshua D Preston
- Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA 30322, USA
- Nutrition & Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
| | - Caroline S Jansen
- Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA 30322, USA
- Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Siddhartha Kosaraju
- Division of Neuroradiology, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Tim Niyogusaba
- Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Tony Z Zhuang
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sally W Iwamoto
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Spencer K Hutto
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mary Jo Lechowicz
- Department of Hematology & Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
| | - Pamela B Allen
- Department of Hematology & Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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6
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Ashok Kumar P, Sivapiragasam A, Wang D, Huang D, Gentile T. Descriptive Analysis and Factors Influencing Survival in Patients With Primary Cutaneous Gamma-Delta T Cell Lymphoma. A Retrospective National Cancer Database Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:897-904. [PMID: 37690902 DOI: 10.1016/j.clml.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Gamma delta T cells gives rise to a rare malignancy called Primary cutaneous Gamma-Delta T cell lymphoma (PCGDTCL). METHODS From the National Cancer Database (NCDB), 110 (0.015%) patients with PCGDTCL were identified. RESULTS Males aged >60 years were the commonest cohort. Caucasian race was the most common (Caucasian: 79.09%, African American:16.36%). Most patients were diagnosed at stage 1 (52.33%), followed by stage 4 (30.23%). On analyzing income categories, <$48,000 group had 48.15% stage 4 (13/27) and 40.74% (11/27) stage 1. Overall survival (OS) of the study group at 3 years by Kaplan-Meier (KM) analysis was 46.6%. African American race (37.5%), income of <$48,000 (27.6%) and government insurance (38.8%) had lower survival rates in KM analysis. In the adjusted hazard ratio (HR) analysis, only age <=40 years compared to >60 years (0.165 [0.036, 0.768], P= .0217) reached significance. Although the group that did not receive any chemotherapy or radiation seemed to have a better survival by KM analysis at 74.3% at 3 years, significance was not seen in the adjusted HR estimates and majority of the patients in this group were stage 1. This group may have received topical treatments which may have not been captured in NCDB. Adjusted analysis also revealed chemoradiation to have a lower mortality risk compared to chemotherapy alone (0.229 [0.079, 0.670], P = .0071), suggesting that aggressive strategies may be required for management when needed. CONCLUSION Socioeconomic disparities significantly impact access to healthcare and are of particular importance in rare lymphomas.
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Affiliation(s)
- Prashanth Ashok Kumar
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY.
| | - Abirami Sivapiragasam
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, Upstate University Hospital, Syracuse, NY
| | - Danning Huang
- Department of Public Health and Preventive Medicine, Upstate University Hospital, Syracuse, NY
| | - Teresa Gentile
- Division of Hematology-Oncology, Upstate Cancer Center, Upstate University Hospital, Syracuse, NY
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7
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Zengarini C, Baruffaldi G, Piraccini BM, Bardazzi F, Mussi M, Hrvatin Stancic B, Pileri A. Nb-UVB and PUVA therapy in treating early stages of Mycosis Fungoides: A single-center cross-sectional study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:435-440. [PMID: 36974002 DOI: 10.1111/phpp.12873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Mycosis fungoides (MF) and Sezary Syndrome are the most common forms of cutaneous T-cell lymphoma. Early-stage MF is known to have an indolent behavior, and the EORTC guidelines recommend treating patients with skin-directed therapies, such as phototherapy, instead of systemic therapies. Phototherapy is a popular therapeutic option, with two commonly used light sources-PUVA and narrow band-nb UVB. PUVA is less commonly used due to its potential carcinogenic role, but it has systemic effects, while nb-UVB has mostly skin-limited effects. There is ongoing debate regarding the role of UVB light, and in 2021, the Cutaneous Lymphoma Italian Study Group reached a consensus on technical schedules for NB-UVB and PUVA for MF. This study aims to analyze and compare the efficacy of the two phototherapy options in treating early-MF patients. MATERIALS AND METHODS The study included patients diagnosed with stage IA/B MF in the last 10 years, who had at least 12 months of follow-up data and a minimum of 24 phototherapy sessions (PUVA or nb UVB) and treated with topical steroids apart from phototherapy. RESULTS Results showed that the two phototherapy options were similarly effective in treating early MF, with no significant differences in clinical response, although PUVA was associated with more adverse effects. CONCLUSIONS The study provides valuable insights into the use of phototherapy in early MF, and the results can be used to guide treatment decisions and improve patient outcomes.
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Affiliation(s)
- Corrado Zengarini
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Gregorio Baruffaldi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Bardazzi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Martina Mussi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | | | - Alessandro Pileri
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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8
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Velarde Loya M, Millan Reza MG, Olaya Cordova M, Chavéz López ZD. Probable Primary Cutaneous CD8+ Aggressive Epidermotropic Cytotoxic T-cell Lymphoma: A Case Report of a Diagnostic Challenge. Cureus 2023; 15:e44375. [PMID: 37654908 PMCID: PMC10467331 DOI: 10.7759/cureus.44375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/02/2023] Open
Abstract
Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma is a rare variety of cutaneous lymphoma. This subtype has an aggressive and quickly progressive clinical course with a survival time of 32 months from the commencement of skin lesions. This article describes a probable case of primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma in a 63-year-old female, which manifested as diffuse non-pruritic erythematous plaques and nodules. The diagnosis of this possible entity was aided by the histopathological and immunohistochemical findings, while immunohistochemistry for T-cell receptor (TCR) gamma/delta could not be done.
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Affiliation(s)
- Marcela Velarde Loya
- Internal Medicine Residency, Hospital General Presidente Lázaro Cárdenas, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Chihuahua, MEX
| | - Monica G Millan Reza
- Internal Medicine Residency, Hospital General Presidente Lázaro Cárdenas, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Chihuahua, MEX
| | - Mariana Olaya Cordova
- Internal Medicine Residency, Hospital General Presidente Lázaro Cárdenas, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Chihuahua, MEX
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9
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Kouhen F, Oqbani K, El Gouach H, Ahnach M, Dahbi Z. Overcoming Chemotherapy Resistance in Cutaneous T-Cell Lymphoma: A Successful Case of High-Dose Radiotherapy Management. Cureus 2023; 15:e43959. [PMID: 37746484 PMCID: PMC10514740 DOI: 10.7759/cureus.43959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
The management of refractory cutaneous T-cell lymphoma (CTCL) is challenging and requires a multimodal approach. Radiotherapy is one of the treatment options used in managing CTCL, particularly for localized disease or as a palliative measure to control symptoms in advanced cases. The rarity of the disease makes it difficult to conduct extensive clinical trials and gather sufficient data on the most effective treatment approaches. Lymphocytes are among the most sensitive cells to radiation's damaging effects. Because of this sensitivity, radiation therapy can be an effective treatment. This case illustrates the efficacy of radiotherapy and its potential as an effective treatment alternative for a severe and resistant CTCL to systemic therapy in a 61-year-old Moroccan patient. The patient underwent curative high-dose radiation therapy, utilizing three-dimensional conformal radiation therapy. At the 19-month follow-up post-radiotherapy, no evidence of local recurrence, either clinically or radiologically, was observed, and the patient maintained a good quality of life with unrestricted mobility of his arm.
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Affiliation(s)
- Fadila Kouhen
- Laboratory of Neurosciences and Oncogenetics, Department of Radiotherapy, Mohammed VI Center for Research and Innovation, International University Hospital Sheikh Khalifa, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, MAR
| | - Kenza Oqbani
- Department of Pathology, International University Hospital Sheikh Khalifa, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, MAR
| | - Hanae El Gouach
- Laboratory of Neurosciences and Oncogenetics, Department of Radiotherapy, Mohammed VI Center for Research and Innovation, International University Hospital Sheikh Khalifa, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, MAR
| | - Meriem Ahnach
- Department of Hematology, International University Hospital Sheikh Khalifa, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, MAR
| | - Zineb Dahbi
- Department of Radiotherapy, International University Hospital Sheikh Khalifa, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, MAR
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10
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Groenen PJTA, van den Brand M, Kroeze LI, Amir AL, Hebeda KM. Read the clonotype: Next-generation sequencing-based lymphocyte clonality analysis and perspectives for application in pathology. Front Oncol 2023; 13:1107171. [PMID: 36845702 PMCID: PMC9945094 DOI: 10.3389/fonc.2023.1107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
Clonality assessment using the unique rearrangements of immunoglobulin (IG) and T-cell receptor (TR) genes in lymphocytes is a widely applied supplementary test for the diagnosis of B-cell and T-cell lymphoma. To enable a more sensitive detection and a more precise comparison of clones compared with conventional clonality analysis based on fragment analysis, the EuroClonality NGS Working Group developed and validated a next-generation sequencing (NGS)-based clonality assay for detection of the IG heavy and kappa light chain and TR gene rearrangements for formalin-fixed and paraffin-embedded tissues. We outline the features and advantages of NGS-based clonality detection and discuss potential applications for NGS-based clonality testing in pathology, including site specific lymphoproliferations, immunodeficiency and autoimmune disease and primary and relapsed lymphomas. Also, we briefly discuss the role of T-cell repertoire of reactive lymphocytic infiltrations in solid tumors and B-lymphoma.
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Affiliation(s)
- Patricia J. T. A. Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands,*Correspondence: Patricia J. T. A. Groenen,
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Pathology-DNA, Location Rijnstate Hospital, Arnhem, Netherlands
| | - Leonie I. Kroeze
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Avital L. Amir
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
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11
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Improved semiautomated detection of TRBC-restricted Sézary cells unveils a spectrum of clonal cluster immunophenotypes. Blood 2022; 140:2852-2856. [PMID: 36037427 DOI: 10.1182/blood.2022017548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 01/05/2023] Open
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12
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Youn SH, Lee SY. Advanced stage cutaneous T-cell lymphoma treated with high-dose external beam radiation therapy: A case report. Medicine (Baltimore) 2022; 101:e32239. [PMID: 36595796 PMCID: PMC9794289 DOI: 10.1097/md.0000000000032239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The treatment for advanced-stage or refractory cutaneous T-cell lymphoma (CTCL) is largely palliative. Due to the rarity of the disease, there are few randomized controlled trials and large-scale prospective studies. Therefore, the treatment of advanced-stage CTCL remains challenging. PATIENT CONCERNS AND DIAGNOSIS A 64-years-old man who had received narrowband UVB phototherapy for several years presented with a generalized rash with widespread polycyclic erosions and painful ulcers on his hands and feet. We restaged him as stage III CTCL. INTERVENTIONS AND OUTCOMES He was treated with high-dose radiation for curative purposes and 3-dimensional conformal radiation therapy to both hands and feet. At the 2-year follow-up after the end of radiotherapy, the irradiated skin had recovered to normal soft, smooth skin with localized fibrosis and hypopigmented skin. He reported an excellent quality of life, and his hands and feet were free to move. CONCLUSION CTCL at an advanced stage could require dose escalation with local radiotherapy for curative purposes. High-dose 3-dementional conformal radiation therapy could be effective and has tolerable toxicities.
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Affiliation(s)
- Sang Hee Youn
- Departments of Radiation Oncology, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sun Young Lee
- Departments of Radiation Oncology, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- * Correspondence: Sun Young Lee, Department of Radiation Oncology, Jeonbuk National University Hospital, 634-18 Keuman-dong, Dukjin-gu, Jeonju, 54907, Republic of Korea (e-mail: )
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Jin J, Chen Z, Cao Z, Zhou S, Zhang X, Yao H. Epstein-Barr virus-associated leiomyosarcoma of the larynx in an adult patient with human immunodeficiency virus infection: Case report and review of the literature. Head Neck 2022; 44:2886-2903. [PMID: 36069494 PMCID: PMC9826281 DOI: 10.1002/hed.27184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/07/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023] Open
Abstract
We investigated the clinical features, treatment, and prognosis of laryngeal leiomyosarcoma (LLMS) and Epstein-Barr virus-associated (EBV-associated) LMS. We report a case of EBV-associated LLMS in an adult patient with HIV infection. We also conducted a review of the English-language literature on LLMS and EBV-associated leiomyosarcoma. To the best of our knowledge, 62 cases of LLMS and EBV-associated leiomyosarcoma have been reported to date. Of patients with LLS, 18.9% had distant metastases and 17.0% had local recurrence. The overall 5-year survival rate was 64.0%. Distant metastases affected the survival of patients with LLMS (p = 0.04). EBV-positive patients had a low survival rate (p = 0.01). Among patients with EBV-associated LMS, 8.2% had distant metastases and recurrence and the overall 5-year survival rate was 50.0%. EBV-associated LLMS is rare. The EBV infection might be a poor prognostic factor of LLMS.
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Affiliation(s)
- Jian‐Di Jin
- Department of Infection, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
| | - Zhe Chen
- Department of Otolaryngology, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
| | - Zai‐Zai Cao
- Department of Otolaryngology, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
| | - Shui‐Hong Zhou
- Department of Otolaryngology, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
| | - Xiu‐Ming Zhang
- Department of Pathology, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
| | - Hong‐Tian Yao
- Department of Pathology, The First Affiliated HospitalZhejiang University School of MedicineHangzhou CityP.R. China
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14
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Kim E, Walker A, Bhate C, Chang VT. Brentuximab extravasation injury in a patient with mycosis fungoides with large cell transformation. Dermatol Ther 2022; 35:e15751. [PMID: 35912707 PMCID: PMC9786349 DOI: 10.1111/dth.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/12/2022] [Accepted: 07/30/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Eileen Kim
- Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Amanda Walker
- Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Chinmoy Bhate
- DermatologyRutgers New Jersey Medical SchoolNewarkNew JerseyUSA,DermatologyVeterans Affairs New Jersey Health Care SystemEast OrangeNew JerseyUSA
| | - Victor T. Chang
- Hematology‐OncologyRutgers New Jersey Medical SchoolNewarkNew JerseyUSA,Hematology‐OncologyVeterans Affairs New Jersey Health Care SystemEast OrangeNew JerseyUSA
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15
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The Skin Microbiome in Cutaneous T-Cell Lymphomas (CTCL)—A Narrative Review. Pathogens 2022; 11:pathogens11080935. [PMID: 36015055 PMCID: PMC9414712 DOI: 10.3390/pathogens11080935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
In recent years, numerous studies have shown a significant role of the skin microbiome in the development and exacerbation of skin diseases. Cutaneous T-cell lymphomas (CTCL) are a group of malignancies primary involving skin, with unclear pathogenesis and etiology. As external triggers appear to contribute to chronic skin inflammation and the malignant transformation of T-cells, some microorganisms or dysbiosis may be involved in these processes. Recently, studies analyzing the skin microbiome composition and diversity have been willingly conducted in CTCL patients. In this review, we summarize currently available data on the skin microbiome in CTLC. We refer to a healthy skin microbiome and the contribution of microorganisms in the pathogenesis and progression of other skin diseases, focusing on atopic dermatitis and its similarities to CTCL. Moreover, we present information about the possible role of identified microorganisms in CTCL development and progression. Additionally, we summarize information about the involvement of Staphylococcus aureus in CTCL pathogenesis. This article also presents therapeutic options used in CTCL and discusses how they may influence the microbiome.
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16
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Rupoli S, Goteri G, Morsia E, Torre E, Federica G, Campanati A, Offidani AM, Molinelli E, Brandozzi G, Serresi S, Giacchetti A, Bugatti L, Giorgio F, Mozzicafreddo G, Simonacci M, Olivieri A. Prognosis in early stage cutaneous T-cell lymphoma treated with psoralen plus ultraviolet A irradiation and low-dose Interferon-α: long-term efficacy and survival according to conventional and emerging clinical endpoints. Dermatol Ther 2022; 35:e15737. [PMID: 35903895 DOI: 10.1111/dth.15737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022]
Abstract
Patients with early stage Cutaneous T Cell Lymphoma (CTCL) usually have a benign and chronic disease course, characterized by temporally response to conventional skin directed therapies and intrinsic possibility to evolve. Using the combination of psoralen plus ultraviolet A irradiation (PUVA) and low-dose Interferon-α (INF), the principal treatment goal is to keep confined the disease to the skin, preventing disease progression. Among 87 patients with early stage IA to IIA MF treated with low-dose IFN-α2b and PUVA in our Center, complete remission (CR) were reported in 70 patients (80.5%) and the overall response rate (ORR) was 97.8% (n=85), with a median time to best response to therapy of 5 months (range, 1-30). Among the responders, only the 8% of patients had a relapse with major event. The median follow-up was 207 months (range, 6-295). Survival data showed a median overall survival (OS) not reached (95% CI; 235-NR months), a disease free survival (DFS) of 210 months (95% CI; 200-226 months) and a median time to next treatment (TTNT) of 38.5 months (95% CI, 33-46 months). The long follow up of this study verifies our preliminary results already published in 2006 and confirms the efficacy of INF-PUVA combination therapy in a real world setting, according conventional (OS and DFS) and emerging (TTNT) clinical endpoint of treatment efficacy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Serena Rupoli
- Clinica di Ematologia, Università Politecnica delle Marche, Italy
| | | | - Erika Morsia
- Clinica di Ematologia, Università Politecnica delle Marche, Italy
| | - Elena Torre
- Clinica di Ematologia, Università Politecnica delle Marche, Italy
| | | | - Anna Campanati
- Clinica di Dermatologia, Dipartimento di scienze cliniche e molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Anna Maria Offidani
- Clinica di Dermatologia, Dipartimento di scienze cliniche e molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Elisa Molinelli
- Clinica di Dermatologia, Dipartimento di scienze cliniche e molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Giuliano Brandozzi
- Clinica di Dermatologia, Dipartimento di scienze cliniche e molecolari, Università Politecnica delle Marche, Ancona, Italy
| | | | | | | | - Filosa Giorgio
- Unità di Dermatologia, Carlo Urbani Hospital, Jesi, Italy
| | | | - Marco Simonacci
- Dipartimento di Dermatologia, Macerata Hospital, Macerata, Italy
| | - Attilio Olivieri
- Clinica di Ematologia, Università Politecnica delle Marche, Italy
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18
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Huang S, Liao M, Chen S, Zhang P, Xu F, Zhang H. Immune signatures of CD4 and CD68 predicts disease progression in cutaneous T cell lymphoma. Am J Transl Res 2022; 14:3037-3051. [PMID: 35702080 PMCID: PMC9185059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cutaneous T-cell lymphoma (CTCL) is highly heterogeneous, and its prognosis is closely related to the disease stage. The tumor microenvironment (TME) is an important component of tumor tissue, driving cancer cell growth, progression, and metastasis. However, the diagnostic value of TME in CTCL has not yet been studied in-depth. To date, no study has performed a comprehensive evaluation of the significance of the TME in CTCL. METHODS Using xCell methods based on bulk RNA sequencing data, we inferred immune cell fraction in the TME in 126 patients and assessed the prognostic importance of immune cells. Consensus clustering was performed to determine the TME subtypes and characterize the transcriptome of each subtype. Based on the TME subtypes, we established the disease progression model using random forest algorithms and logistic regression. The efficacy of the model was examined using an additional 49-patient cohort. Finally, we validated our finding at the protein level using immunochemistry in a 16-patient cohort. RESULTS Patients with advanced CTCL presented with a more active immunity overall than those with early stage. Random forest algorithms revealed that the immune cells CD4, macrophages, and dendritic cells (DCs) were the most effective prognosis predictors. Therefore, we constructed a risk model using logistic regression based on these immune cells. The TME score could be used to effectively predict disease conditions in three datasets with the AUC of 0.9414, 0.7912, and 0.7665, respectively. Immunochemistry at the protein level revealed that helper T cells and the macrophage markers CD4 and CD68 could successfully distinguish different CTCL stages in patients, whereas the DC marker langerin showed no change with disease progression. CONCLUSION We found advanced-stage CTCL was associated with an active immune microenvironment, and the immune signatures CD4 and CD68 showed a relatively high accuracy in predicting CTCL disease progression.
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Affiliation(s)
- Sanling Huang
- Department of Hematology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
| | - Mengying Liao
- Department of Pathology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
| | - Siliang Chen
- Department of Hematology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
| | - Ping Zhang
- Department of Hematology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
| | - Fangzhou Xu
- Department of Hematology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
- The Clinical Trail Institute, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
| | - Hongyu Zhang
- Department of Hematology, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
- The Clinical Trail Institute, Peking University Shenzhen HospitalShenzhen 518000, Guangdong, P. R. China
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19
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Clauzure M, Táquez Delgado MA, Phillip JM, Revuelta MV, Cerchietti L, Medina VA. Histamine H4 Receptor Agonism Induces Antitumor Effects in Human T-Cell Lymphoma. Int J Mol Sci 2022; 23:ijms23031378. [PMID: 35163302 PMCID: PMC8836034 DOI: 10.3390/ijms23031378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 01/16/2022] [Indexed: 02/01/2023] Open
Abstract
The discovery of the human histamine H4 receptor (H4R) has contributed to our understanding of the role of histamine in numerous physiological and pathological conditions, including tumor development and progression. The lymph nodes of patients with malignant lymphomas have shown to contain high levels of histamine, however, less is known regarding the expression and function of the H4R in T-cell lymphoma (TCL). In this work we demonstrate the expression of H4R isoforms (mRNA and protein) in three human aggressive TCL (OCI-Ly12, Karpas 299, and HuT78). Histamine and specific H4R agonists (VUF8430 and JNJ28610244) significantly reduced cell viability in a dose-dependent manner (p < 0.05). The combined treatment with the H4R antagonist (JNJ7777120, 10 µM) reversed the effects of the H4R ligands. Importantly, we screened a drug repurposing library of 433 FDA-approved compounds (1 μM) in combination with histamine (10 μM) in Hut78 cells. Histamine produced a favorable antitumor effect with 18 of these compounds, including the histone deacetylase inhibitor panobinostat. Apoptosis, proliferation, and oxidative stress studies confirmed the antitumoral effects of the combination. We conclude that the H4R is expressed in TCL, and it is involved in histamine-mediated responses.
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Affiliation(s)
- Mariángeles Clauzure
- Laboratory of Tumor Biology and Inflammation, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina (UCA), National Scientific and Technical Research Council (CONICET), Buenos Aires 1107, Argentina; (M.C.); (M.A.T.D.)
- Faculty of Veterinary Science, National University of La Pampa (UNLPam), General Pico 6360, Argentina
| | - Mónica A. Táquez Delgado
- Laboratory of Tumor Biology and Inflammation, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina (UCA), National Scientific and Technical Research Council (CONICET), Buenos Aires 1107, Argentina; (M.C.); (M.A.T.D.)
| | - Jude M. Phillip
- Hematology and Oncology Division, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (J.M.P.); (M.V.R.); (L.C.)
| | - Maria V. Revuelta
- Hematology and Oncology Division, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (J.M.P.); (M.V.R.); (L.C.)
| | - Leandro Cerchietti
- Hematology and Oncology Division, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (J.M.P.); (M.V.R.); (L.C.)
| | - Vanina A. Medina
- Laboratory of Tumor Biology and Inflammation, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina (UCA), National Scientific and Technical Research Council (CONICET), Buenos Aires 1107, Argentina; (M.C.); (M.A.T.D.)
- Correspondence: ; Tel.: +54-11-4349-0200 (ext. 6091)
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20
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Malignant and Benign T Cells Constituting Cutaneous T-Cell Lymphoma. Int J Mol Sci 2021; 22:ijms222312933. [PMID: 34884736 PMCID: PMC8657644 DOI: 10.3390/ijms222312933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 02/06/2023] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of non-Hodgkin lymphoma, including various clinical manifestations, such as mycosis fungoides (MF) and Sézary syndrome (SS). CTCL mostly develops from CD4 T cells with the skin-tropic memory phenotype. Malignant T cells in MF lesions show the phenotype of skin resident memory T cells (TRM), which reside in the peripheral tissues for long periods and do not recirculate. On the other hand, malignant T cells in SS represent the phenotype of central memory T cells (TCM), which are characterized by recirculation to and from the blood and lymphoid tissues. The kinetics and the functional characteristics of malignant cells in CTCL are still unclear due, in part, to the fact that both the malignant cells and the T cells exerting anti-tumor activity possess the same characteristics as T cells. Capturing the features of both the malignant and the benign T cells is necessary for understanding the pathogenesis of CTCL and would lead to new therapeutic strategies specifically targeting the skin malignant T cells or benign T cells.
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