Extracorporeal photochemotherapy in patients with cutaneous T-cell lymphoma: is clinical response predictable?
Version of Record online: 30 AUG 2006
Journal of the European Academy of Dermatology and Venereology
Volume 20, Issue 9, pages 1100–1107, October 2006
How to Cite
Rao, V., Ryggen, K., Aarhaug, M., Dai, H., Jørstad, S. and Moen, T. (2006), Extracorporeal photochemotherapy in patients with cutaneous T-cell lymphoma: is clinical response predictable?. Journal of the European Academy of Dermatology and Venereology, 20: 1100–1107. doi: 10.1111/j.1468-3083.2006.01745.x
- Issue online: 30 AUG 2006
- Version of Record online: 30 AUG 2006
- Received: 13 July 2005, accepted 8 September 2005; DOI: 10.1111/j.1468-3083.2006.01745.x
- mycosis fungoides;
- red man syndrome;
- sezary syndrome
Background Extracorporeal photochemotherapy (ECP) has been accepted as a standard therapy in cutaneous T-cell lymphomas (CTCL), a category of lymphomas mainly resistant to conventional therapies. Approximately one half of patients demonstrate a reduction in skin affliction by at least 50% within 12 months of therapy and are categorized as responders to ECP. Predictive criteria for selecting patients who will respond to ECP are lacking. Such criteria would however, be of great benefit.
Objectives This study compared T-cell clonality and serum levels of soluble interleukin-2 receptor (sIL-2R), lactate dehydrogenase (LD), neopterin, beta2-microglobulin (β2-M) and granzyme B in CTCL patients in order to evaluate their potential usefulness as predictive markers.
Patients/methods Serum and T lymphocytes obtained from 16 patients with CTCL receiving ECP treatment were evaluated in an open retrospective study.
Results We found no evident correlation between detected T-cell clonality and response to ECP. The non-responding group had on average a higher level of serum sIL-2R. This difference was significant after 6 and 12 months of therapy, but not pretreatment. An individual reduction in serum sIL-2R, neopterin and β2-M during a 6-month course of ECP was well correlated to clinical remission.
Conclusions Seven out of 16 patients were classified as responders. Neither T-cell clonality nor any of the serum markers assessed pretreatment could reliably predict the response to ECP treatment. However, the individual relative changes in sIL-2R, neopterin and β2-M during 6 months of ECP treatment coherently displayed correlation to the clinical response, as assessed after 12 months of ECP treatment.