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Prognostic implications of evaluation for lymph node involvement by T- cell
antigen receptor gene rearrangement in mycosis fungoides
JW Lynch , I Linoilla, EA Sausville, SM Steinberg, BC Ghosh, DT Nguyen, GP Schechter, AB Fischmann, DC Ihde and JL Stocker
National Cancer Institute, National Institutes of Health, Bethesda, MD.
We investigated the correlation between the detection of clonal
rearrangement of the T-cell antigen receptor gene (TCRR) in lymph node
tissue with histopathologic lymph node classification in 33 patients with
mycosis fungoides with and without the Sezary Syndrome. We analyzed DNA
extracted from lymph nodes that were histologically uninvolved (LN1-2),
dermatopathic nodes with clusters of atypical cells (LN3), and nodes
effaced with lymphoma (LN4) and found TCRR in none of five LN1-2 nodes, 8
of 17 LN3 nodes, and 10 of 11 LN4 nodes. Further, the detection of TCRR
correlated with presence of palpable adenopathy (P2 less than .0001) and
was associated with a worse survival (P2 = .0024). Within the subgroup of
patients with LN3 nodes, there was a trend (P2 = .14) toward inferior
survival if nodes were involved by TCRR, irrespective of extent of skin
disease. We conclude that detection of TCRR in nodes from mycosis fungoides
patients is an objective and reliable means of assessing tumor infiltration
of lymph node and is associated with an inferior survival.
Volume 79,
Issue 12,
pp. 3293-3299,
06/15/1992
Copyright © 1992 by The American Society of Hematology
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