Frequency and prognostic value of cutaneous molecular residual disease in mycosis fungoides A prospective multicenter trial of the Cutaneous Lymphoma French Study Group.
Fiche publication
Date publication
juillet 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CORNILLET-LEFEBVRE Pascale, Dr DALAC Sophie
Tous les auteurs :
Hurabielle C, Ingen-Housz-Oro S, Ortonne N, Cornillet-Lefebvre P, Merah A, D'Incan M, Joly P, Franck N, Esteve E, Maubec E, Grange F, Machet L, Laroche L, Barete S, Dalac S, Mortier L, Michel C, Quereux G, Saiag P, Ram-Wolff C, Lenormand B, Wechsler J, Bastuji-Garin S, Bagot M, Delfau-Larue MH
Lien Pubmed
Résumé
BACKGROUND: Monoclonal T-cell receptor (TCR) rearrangement is detected in 57% to 75% of early-stage mycosis fungoides (MF) at diagnosis. A retrospective study showed molecular residual disease (MRD) in 31% of patients in complete clinical remission (CR) after 1 year of treatment. OBJECTIVE: To confirm the frequency of MRD at 1 year and to determine its prognostic value for further relapse. METHODS: Patients with T1-, T2- or T4-stage MF were prospectively included in this multicenter study. At diagnosis, clinical lesions and healthy skin were biopsied. After 1 year of topical treatment, previously involved skin (PIS) of patients in CR was biopsied for histology and analysis of TCR-gamma gene rearrangement. Results were compared to the clinical status each year for 4 years. RESULTS: We included 214 patients, 133 at T1, 78 T2, and 3 T4 stage. At diagnosis, 126/204 cases (61.8%) showed TCR clonality in lesional skin. After 1 year, 83/178 patients (46.7%) still being followed up were in CR and 13/63 (20.6%) showed MRD. At 4 years, 55/109 (50.5%) patients still being followed up were in CR and 44/109 were in T1 stage (40.4%). MRD did not affect clinical status at 4 years (CR vs. T1/T2, p=1.0, positive predictive value 36.4%, negative predictive value 67.6%). CONCLUSION: T-cell clonality at diagnosis and MRD at 1 year are not a prognostic factor of clinical status at 4 years. This article is protected by copyright. All rights reserved.
Référence
Br J Dermatol. 2015 Jul 6