Peripheral blood of patients with cutaneous T-cell lymphoma: studies using monoclonal antibodies

Photopheresis--extracorporeal irradiation of 8-MOP containing blood--a new therapeutic modality

In the course of the last four years our group has had experience with the development of an exciting new concept for the treatment of the exfoliative erythrodermic form of cutaneous T cell lymphoma (CTCL), leukemic form, as well as other T cell mediated diseases: extracorporeal photopheresis (EP). In our first experience with this new therapeutic approach, clinical response was observed in 6 of the 7 patients studied. Skin pathology improved significantly so that 5 of 7 patients were able to resume their normal daily activities. Laboratory response was significant in all 7 as measured by a decrease in abnormal T lymphocytes. In spite of an individually adjusted maintenance therapy no significant side effects have been observed. Our initial observations with this new and apparently safe approach for treatment of CTCL and other T cell mediated diseases (e.g. pemphigus vulgaris) suggest that further more extensive clinical trials as well as research into the basic underlying mechanisms involved are warranted.

OKT4/OKT8 ratio and serum beta 2-microglobulin in mycosis fungoides and chronic benign dermatitis

Pre-treatment Serum Beta 2-microglobulin (S B2-m) and OKT4/OKT8 Ratio (T4/T8 R) were studied in 15 patients with Mycosis Fungoides (MF) and in 10 subjects with Chronic Superficial Benign Dermatitis (CSBD) in order to verify whether these parameters may lend support to an earlier differential diagnosis. S B2-m levels and T4/T8 R showed no significant difference in CSBD as compared to normal controls. MF patients displayed elevated S B2-m and T4/T8 R values in comparison to healthy controls and subjects suffering from CSBD (P less than 0.001). After photochemotherapy (PUVA), markedly decreased S B2-m and T4/T8 R values were observed in all patients but two who proved to be unresponsive to PUVA treatment. On the basis of reported data, S B2-m and T4/T8 R can be regarded as an additional tool to discriminate CSBD and MF when clinical and histological features are not significantly diagnostic. Finally, these parameters seem to provide reliable information in monitoring response to treatment.

Cutaneous T cell lymphoma

Cutaneous T cell lymphoma is a malignancy of helper T cells, which have a propensity to infiltrate the skin. The incidence of the disease appears to exceed that of Hodgkin's disease, making it the most common lymphoma of adults. Advances in our knowledge of the biology of the malignant T cells should facilitate new and more effective forms of treatment.

Monoclonal antibodies and the skin biopsy: current and potential clinical applications

Monoclonal antibodies are becoming increasingly useful in the clinical diagnosis and/or treatment of a number of unrelated diseases. Discussion will be directed to those monoclonal antibodies recognizing antigens within the skin which appear to have either proven or potential application in the diagnostic evaluation of the skin biopsy.

Monoclonal antibodies and cutaneous T cell lymphoma. Theoretical and practical considerations

The T cell nature of mycosis fungoides and Sézary syndrome was established a decade ago. The recent advent of monoclonal antibodies to T cells and other lymphoid subpopulations has resulted in an explosion of knowledge on the biology of this group of disorders. These reagents have increased our knowledge on thymic differentiation status, pathogenesis, the phenotype of premalignant vs malignant lymphocytic infiltrates, the identification of other previously unrecognized cells within lymphomas, and the phenotype of circulating vs skin lymphocytes. Therapeutic applications may result. These new developments are discussed.