Document 0570
 DOCN  M9440570
 TI    Profound deficiency in normal circulating T cells in erythrodermic
       cutaneous T-cell lymphoma.
 DT    9404
 AU    Heald P; Yan SL; Edelson R; Department of Dermatology, Yale University
       School of Medicine,; New Haven, Conn.
 SO    Arch Dermatol. 1994 Feb;130(2):198-203. Unique Identifier : AIDSLINE
       MED/94137045
 AB    BACKGROUND AND DESIGN: To accurately assess tumor burden in cutaneous
       T-cell lymphoma as well as to determine the number of residual normal
       circulating T cells, it is necessary to accurately distinguish malignant
       cells. Because cutaneous T-cell lymphoma cells regularly display many
       normal phenotypic markers of T cells (CD2+, CD3+, CD4+) these surface
       proteins have been of limited value. We have used a set of monoclonal
       antibodies with specificity for those T-cell receptor proteins
       containing variable regions on the beta chain to distinguish normal from
       malignant T cells in patients with cutaneous T-cell lymphoma. RESULTS:
       The results revealed an unanticipated and profound expansion of the
       malignant cell populations (59% to 87% of blood T cells) in six patients
       with total T-cell counts in the normal or near normal range. By
       subtracting the percentages of malignant T cells, identified in this
       manner, from the total T-cell counts, we found that the residual normal
       T-cell compartments were small (0 to 0.155 x 10(9)/L) in four of the six
       patients. Sezary cell counts by peripheral blood smear analysis by
       routine light microscopy underestimated the number of malignant T cells.
       Markedly elevated CD4/CD8 ratios (10 to 90) occurred in all cases,
       reflecting expansion of the CD4+ malignant population and parallel
       reduction of the normal residual CD8+ subset. CONCLUSIONS: Patients with
       erythrodermic cutaneous T-cell lymphoma often have markedly depressed
       levels of normal blood T cells, to the range seen in advanced acquired
       immunodeficiency syndrome, and absolute numbers of malignant cells
       substantially exceed those recognized with less sensitive techniques.
 DE    CD4-CD8 Ratio  Flow Cytometry  Fluorescent Antibody Technique  Human
       Leukocyte Count  Lymphoma, T-Cell, Cutaneous/*BLOOD  Receptors, Antigen,
       T-Cell/ISOLATION & PURIF  Sezary Syndrome/*BLOOD  Skin Neoplasms/*BLOOD
       Support, U.S. Gov't, P.H.S.  T-Lymphocytes/IMMUNOLOGY/*PATHOLOGY
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).