Polymerase Chain Reaction(PCR) analysis of TCR gene rearrangement is a simple and fast method to determine the presence of monoclonal T lymphoid cells. We performed a prospective study designed to evaluate T cell monoclonality in skin and peripheral blood samples of early stages MF patients who received a combination therapy of IFNa2b plus PUVA. PCR amplification of T cell receptor-y chain gene was performed in a total of 35 specimens obtained from 13 patients with MF (6 in stage IA. 4 in stage IB, 3 in stage IIA), both at diagnosis and at the end of therapy. At diagnosis, clonal TCR-Y rearrangements were found in 8 out of 13 patients (61.5%); during the follow-up period the same monoclonal band was detected in biopsy samples from four patients, while in other four cases monoclonality was lost. Three out of the four patients with evidence of monoclonality showed also clinical and/or histological persistence of the disease during the follow-up period. All the patients in which TCR-PCR analysis failed to detect the malignant clone at the end of the therapy, achieved clinical and histological stable remission. The five cases that were negative by PCR at diagnosis still lacked evidence of monoclonality on the subsequent biopsies: two showed clinical and histological relapse and the other three remained in clinical persistent remission. In addition to skin biopsy samples, 21 blood specimens from 12 patients were analyzed by PCR technique to investigate a possible extracutaneous spread of MF. The peripheral blood was free of disease by PCR in 11 out o f 12 patients. In conclusion PCR can be utilized in the monitoring of these disease and IFNcc2b plus PUVA may eradicate malignant cells at molecular level but a longer follow-up is warranted.
|Issue number||11 PART II|
|Publication status||Published - 2000|
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