Case Report
Monitoring the extracorporeal photopheresis by immunophenotyping in a Sézary syndrome patient
Tânia Rodriguesa,b,, Sérgio Lopesb, Catarina Pinhob, Susana Ronconb,,
a Liga Portuguesa Contra o Cancro, Núcleo Regional do Norte, Porto, Portugal
b Serviço de Terapia Celular, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal
Received 01 March 2017, Accepted 26 April 2017
Abstract

The extracorporeal photopheresis is indicated as immunomodulatory treatment in primary cutaneous T-cell lymphoma. There are no guidelines about the most suitable immunophenotypic panel to monitor and correlate clinical evolution and laboratory parameters.

In this study we characterize a patient with Sézary syndrome stage III, who performed 98 sessions of photopheresis; in the last 30, the expression of T-cells in peripheral blood was evaluated.

The patient had exfoliative dermatitis (mainly in the lower limbs) and several analytical disorders: anemia, neutropenia and lymphocytosis; abnormal number of effector T-cells and a CD4/CD8 ratio higher than 10; atypical cells (CD7, CD26) with aberrant phenotype (characteristic of malignant T-cell clones); and regulatory T-cells indicating an immunotolerance state. The clinical evolution verified can be related with the therapeutic scheme adopted.

We propose a multiparameter flow cytometry approach to monitor patients with Sézary syndrome that realize photopheresis, including the aberrant cases.

Keywords
T cell lymphoma, Sézary syndrome, Extracorporeal photopheresis, Immunophenotyping

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