Evaluation of blood parameters for the monitoring of erythrodermic cutaneous T-cell lymphoma

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Abstract

Background and Objectives:

Erythrodermic cutaneous T-cell lymphomas are aggressive diseases posing diagnostic and therapeutic challenges. Numerous indicators for confirming diagnosis and disease-monitoring have been proposed. CD26-negativity of peripheral CD4+ T-cells has been reported to have these properties. Our aim was to test, if the CD4+ T-cell count, fraction of CD26- or CD7-negative CD4+ T-cells during the course of disease are valuable markers to predict therapeutic efficacy or disease progression in relation to changes in skin status.

Patients and Methods:

Retrospective cohort analysis of eleven patients treated at a tertiary referral centre. Statistics were done by linear regression analysis and logrank test.

Results:

Five patients displayed response to therapy in the skin, nine in the blood. Patients with cutaneous response showed a decrease of CD4+ T-cells, preceding the clinical response in most patients, whereas the percentage of CD26-negative T-cells changed first during clinical improvement. The calculated positive predictive values for response or progression were low for both CD4-count and CD26-expression.

Conclusions:

CD26 is not a reliable marker of either response or progression. As cutaneous response was always associated with a response in blood and not vice versa, we conclude, that the clinical status represents the most important parameter for guiding therapeutic decisions.

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