Simplified Flow Cytometric Assessment in Mycosis Fungoides and Sezary Syndrome

By using flow cytometry with markers for CD3, CD4, CD26, and CD7, we examined the blood samples of 109 patients for abnormal T cells: 69 patients with mycosis fungoides (MF)/Sezary syndrome (SS), 31 hospitalized control subjects, and 9 patients with inflammatory skin disease. T cells were identified as quantitatively abnormal (> 15% CD26- or CD7- T cells) or phenotypically abnormal (CD26- or CD7- T cells with bright or dim CD3 or CD4 or bright CD 7). Patients were followed for a median of 82 months, and abnormal T cells were correlated with diagnosis, clinical outcome, and other laboratory parameters. Abnormal T-cell populations were identified in 46% of patients with MF/SS (32/69) and correlated with disease extent. Quantitative abnormalities were more frequent than phenotypic abnormalities, and CD4+/CD26- T cells were more frequent than CD4+/CD7- T cells. CD26- T cells correlated better with disease extent than did CD7-. Increasing numbers of abnormal T cells were associated with worsening disease. Flow cytometry provides valuable information for diagnosis, prognosis, and therapeutic efficacy in MF/SS.