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The effect of extracorporeal photopheresis alone or in combination therapy on circulating CD 4 + Foxp3 + CD 25 − T cells in patients with leukemic cutaneous T‐cell lymphoma
Author(s) -
Shiue Lisa H.,
Couturier Jacob,
Lewis Dorothy E.,
Wei Caimiao,
Ni Xiao,
Duvic Madeleine
Publication year - 2015
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12175
Subject(s) - cd8 , il 2 receptor , medicine , photopheresis , extracorporeal photopheresis , leukapheresis , foxp3 , immunology , cutaneous t cell lymphoma , cd3 , t cell , gastroenterology , mycosis fungoides , lymphoma , immune system , biology , transplantation , graft versus host disease , stem cell , cd34 , genetics
Purpose Extracorporeal photopheresis ( ECP ) alone or in combination therapy is effective for treatment of leukemic cutaneous T‐cell lymphoma ( L‐CTCL ), but its mechanism(s) of action remain unclear. This study was designed to investigate the effect of ECP on regulatory T cells and CD8 + T cells in L‐CTCL patients. Experimental Design Peripheral blood from 18 L‐CTCL patients at baseline, Day 2, 1 month, 3 month, and 6 month post‐ECP therapy was analyzed by flow cytometry for CD4 + CD25 +/high , CD4 + Foxp3 + CD25 +/− , CD3 + CD8 + , CD3 + CD8 + CD69 + , and CD3 + CD8 + IFN‐γ + T cells. Clinical responses were assessed and correlated with changes in these T‐cell subsets. Results Twelve of 18 patients achieved clinical responses. The average baseline number of CD4 + CD25 +/high T cells of PBMCs in L‐CTCL patients was normal (2.2%), but increased at 6‐month post‐therapy (4.3%, P < 0.01). The average baseline number of CD4 + Foxp3 + T cells out of CD4 + T cells in nine evaluable patients was high (66.8 ± 13.7%), mostly CD25 negative. The levels of CD4 + Foxp3 + T cells in responders were higher ( n = 6, 93.1 ± 5.7%) than nonresponders ( n = 3, 14.2 ± 16.0%, P < 0.01), and they declined in parallel with malignant T cells. The numbers of CD3 + CD8 + CD69 + and CD3 + CD8 + IFN‐γ + T cells increased at 3‐month post‐therapy in five of six patients studied. Conclusions Extracorporeal photopheresis alone or in combination therapy might be effective in L‐CTCL patients whose malignant T cells have a CD4 + Foxp3 + CD25 − phenotype.