Τίτλος:
Blood classification and blood response criteria in mycosis fungoides and Sézary syndrome using flow cytometry: recommendations from the EORTC cutaneous lymphoma task force
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Our current mycosis fungoides (MF) and Sézary Syndrome (SS) staging system includes blood-classification from B0-B2 for patch/plaque/tumour or erythroderma based on manual Sézary counts but results from our EORTC survey confirm these are rarely performed in patch/plaque/tumour MF, and there is a trend towards using flow cytometry to measure blood-class. Accurately assigning blood-class effects overall stage and the ‘global response’ used to measure treatment responses in MF/SS and hence impacts management. The EORTC Cutaneous Lymphoma Task Force Committee have reviewed the literature and held a Workshop (June 2017) to agree a definition of blood-class according to flow cytometry. No large study comparing blood-class as defined by Sézary count with flow cytometry has been performed in MF/SS. The definition of blood-class by flow cytometry varies between publications. Low-level blood involvement occurs in patch/plaque/tumour much less than erythroderma (p < 0.001). The prognostic relevance of blood involvement (B1 or B2) in patch/plaque/tumour is not known. Studies have not shown a statistically worse difference in prognosis in erythrodermic MF patients with low-level blood involvement (IIIB) versus those without (IIIA), but Sezary patients who by definition have a leukaemic blood picture (staged IVA1 or higher) have a worse prognosis. For consistency flow, definition for blood-class must be an objective measurement. We propose absolute counts of either CD4+CD7-or CD4+CD26-where B0<250/μL, B1 = 250/μl–<1000/μL and B2≥1000/μL plus a T-cell blood clone. Fluctuations between B0 and B1 should not be considered in the treatment response criteria until further prognostic information is known. © 2018 The Authors
Συγγραφείς:
Scarisbrick, J.J.
Hodak, E.
Bagot, M.
Stranzenbach, R.
Stadler, R.
Ortiz-Romero, P.L.
Papadavid, E.
Evison, F.
Knobler, R.
Quaglino, P.
Vermeer, M.H.
Περιοδικό:
EUROPEAN JOURNAL OF CANCER
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
blood; cancer prognosis; cancer staging; cancer survival; CD3+ T lymphocyte; CD4 CD8 ratio; CD4 lymphocyte count; CD4+ T lymphocyte; cell clone; classification; disease specific survival; erythroderma; flow cytometry; human; International Prognostic Index; mycosis fungoides; overall survival; priority journal; Review; Sezary syndrome; treatment response; tumor volume; blood; classification; flow cytometry; lymphoma; mycosis fungoides; pathology; procedures; Sezary syndrome; skin tumor, Flow Cytometry; Humans; Lymphoma; Mycosis Fungoides; Neoplasm Staging; Sezary Syndrome; Skin Neoplasms
DOI:
10.1016/j.ejca.2018.01.076
