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Minimal residual disease in mycosis fungoides follow‐up can be assessed by polymerase chain reaction
Author(s) -
PoszepczynskaGuigne E.,
Bagot M.,
Wechsler J.,
Revuz J.,
Farcet JP.,
DelfauLarue MH.
Publication year - 2003
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.2003.05030.x
Subject(s) - mycosis fungoides , gene rearrangement , clone (java method) , polymerase chain reaction , peripheral t cell lymphoma , t cell receptor , biopsy , minimal residual disease , medicine , multiplex polymerase chain reaction , stage (stratigraphy) , pathology , t cell , gastroenterology , biology , lymphoma , immunology , gene , bone marrow , paleontology , biochemistry , immune system
Summary Background T‐cell receptor (TCR) gene rearrangement analysis, i.e. T‐cell clonality, using polymerase chain reaction (PCR) is a routine method used to assess the presence of a cutaneous dominant T‐cell clone in mycosis fungoides (MF). Objectives To compare the outcome of cutaneous lesions of MF after treatment with the fate of the cutaneous T‐cell clonality, and to determine whether minimal residual disease can be detected in patients in clinical complete remission. Methods Fifty‐one patients histologically diagnosed as having MF (17 stage IA, 21 stage IB and 13 stage III) were included in this retrospective study. T‐cell clonality was analysed by GC‐clamp multiplex PCRγ‐denaturing gradient gel electrophoresis. Every patient had two cutaneous biopsies at least 3 months apart. The second biopsy was performed at the site of a treated lesion. Results The presence or absence of a dominant T‐cell clone in the skin remained identical in 26 of the 31 (84%) patients with persistent disease. Thirteen patients with a detectable dominant T‐cell clone at diagnosis went into complete clinical remission. In nine of these 13 (69%) patients, the T‐cell clone was no longer detectable after treatment. The remaining four (31%) patients had an unchanged T‐cell clonality. Conclusions The TCR gene rearrangement imprint is a stable and reliable tumour marker of MF disease. One‐third of patients in complete clinical remission had a cutaneous molecular residual disease, the prognostic value of which will be analysed in an ongoing prospective study.