Abstract
In advanced stages, cutaneous T cell lymphomas (CTCL) are associated with increased mortality from infections and also increased susceptibility to skin malignancies. In this study, we analyzed the complexity of the peripheral blood T cell repertoire with a sensitive b-variable (BV) complementarity-determining region 3 (CDR3) spectratyping analysis and flow cytometry in three-stage IV CTCL/Sezary syndrome patients who achieved complete clinical remission after therapy. The T cell repertoire of peripheral blood T cells before treatment was profoundly abnormal across multiple BV subfamilies. Following treatment, CDR3 spectratype patterns showed dramatic restoration of normal diversity and complexity. However, absolute CD4 counts across multiple BV families remained low for many months, even after identifiable circulating malignant T cell populations were eliminated. These data suggest that the diversity of the T cell repertoire can be recovered after successful treatment of even advanced CTCL.
Publication types
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Research Support, N.I.H., Extramural
MeSH terms
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Aged
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Aged, 80 and over
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Blood Circulation / immunology
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CD4-Positive T-Lymphocytes / drug effects
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CD4-Positive T-Lymphocytes / immunology
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CD4-Positive T-Lymphocytes / metabolism*
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CD4-Positive T-Lymphocytes / pathology
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Cell Separation
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Diphtheria Toxin / therapeutic use
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Female
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Flow Cytometry
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Humans
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Interferon-alpha / therapeutic use
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Interleukin-2 / therapeutic use
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Lymphoma, T-Cell, Cutaneous / drug therapy
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Lymphoma, T-Cell, Cutaneous / genetics*
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Lymphoma, T-Cell, Cutaneous / pathology
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Lymphoma, T-Cell, Cutaneous / physiopathology*
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Male
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Middle Aged
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Neoplasm Staging
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Receptors, Antigen, T-Cell / genetics*
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Recombinant Fusion Proteins / therapeutic use
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Remission Induction
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Skin / blood supply
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Skin / immunology
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Skin / pathology
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T-Lymphocyte Subsets / drug effects
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T-Lymphocyte Subsets / immunology
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T-Lymphocyte Subsets / metabolism*
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T-Lymphocyte Subsets / pathology
Substances
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Diphtheria Toxin
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Interferon-alpha
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Interleukin-2
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Receptors, Antigen, T-Cell
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Recombinant Fusion Proteins
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denileukin diftitox