Search

Background: Chronic dermatoses, as well as Sézary syndrome (SS), the erythrodermic and leukaemic cutaneous T-cell lymphoma, display a T-cell memory pattern. Recent findings suggest that different memory T-cell subsets can be recognized based on CD27 and CD45RO/RA expression. No data are reported as to CD27 expression in SS., Objectives: To evaluate different memory T-cell subsets, i.e. central memory (TCM), effector memory (TEM) and terminally differentiated cells in SS and inflammatory erythroderma (IE)., Materials and Methods: Forty SS and 137 IE patients were included. CD27 and CD45RO/CD45RA expression was analysed by flow cytometry on peripheral blood lymphocytes and immunohistochemistry., Results: A significantly higher expression of the CD4+CD27+CD45RA- TCM subset was observed in SS whilst IE patients were characterized by increased CD4+CD27-CD45RA- TEM levels. The Vbeta-restricted population was homogeneously CD4+CD26-CD27+ in the SS subjects., Conclusions: SS and IE are characterized by a different memory T-cell subset expression; CD27 expression could be used as an additional diagnostic tool in the differential diagnosis.

Background: Response of cutaneous T-cell lymphoma (CTCL) to systemic chemotherapy is unsatisfactory: despite an initially high response rate (RR), duration is always short-lived., Objective: To investigate the capability of a third-generation regimen including idarubicin in improving RR and response duration in CTCL patients., Methods: Twenty-five patients with advanced CTCL (stages IIB and IV) were treated with a 12-week polychemotherapeutic regimen (VICOP-B), which foresees the use of idarubicin in association with etoposide, cyclophosphamide, vincristine, prednisone and bleomycin., Results: The overall objective RR was 80% (36% complete response). The mycosis fungoides (MF) RR was 84%, with a median duration of 8.7 months. The pleomorphic-lymphoma RR was higher (100%), but the corresponding response duration was shorter (median: 3 months). No responses were documented in Sézary syndrome., Conclusion: VICOP-B regimen is effective and feasible as first-line chemotherapy in advanced MF, with or without extracutaneous involvement.

Background: The poor prognosis of stage IIIb melanoma (5-year survival: 36%) shows the need for effective adjuvant therapy to prolong disease-free survival., Objective: The feasibility and efficacy of interferon alfa-2b (IFN-alpha) therapy in stage IIIb melanoma patients was investigated., Methods: alpha-IFN was given at a dose of 3 MU i.m. three times a week to 50 patients. Clinical and immunological controls were carried out., Results: The median follow-up was 43 months (range 5-84). Median survival was 43 months and median disease-free survival 39 months. Overall 5-year survival (62%) was higher than that reported in the literature to date. A significant increase of circulating CD56+ and DR+ lymphocytes after therapy was more evident in disease-free patients than in those with progressing disease., Conclusions: Adjuvant IFN-alpha therapy in stage IIIb melanoma patients is well tolerated and seems to increase survival. However, multicenter randomized trials are needed to confirm these preliminary findings.

Serum levels of soluble(s) interleukin-2 receptor (IL-2R), sCD4 and SCD8 were analysed in 227 melanoma patients, using a sandwich enzyme immunoassay. Different stages of the disease were considered, and a longitudinal study with a 2-year follow-up was performed. Mean values of sIL-2R were significantly higher than in normal controls in all stages and correlated with the disease progression. sCD8 increases with stage progression were less striking, while sCD4 values were always in the normal range. We conclude that sIL-2R measurement is a useful clinical parameter in monitoring disease evolution in melanoma.