PracticeUpdate Conference Series: IID 2018

CD8-Positive T Cells Predict Disease Progression and Drive Visible Inflammation in Cutaneous T-Cell Lymphoma Two studies employing skin biopsy analysis pointed to a predictor of disease progression and a driver of visible inflammation in cutaneous T-cell lymphoma. Results were reported at IID 2018.

CD8-positive T cells as predictors of disease progression E dward Seger, MS, of the State University of New York Downstate Medical Center in Brooklyn, working in the laboratory of John O’Malley, MD, PhD, at the Dana-Farber/Brigham and Women’s Cancer Center in Boston, Massachusetts, explained that among the challenges of caring for patients with mycosis fungoides, the most common of the cutaneous T-cell lymphomas, is early identification of patients who will develop progressive disease. Mr. Seger explained to Elsevier’s PracticeUpdate , “Risk-stratifying patients with cutaneous T-cell lymphoma has remained a challenge. While many will experience an indolent disease course and a normal life expectancy, a small subset will progress to more advanced and potentially lethal disease. We are attempting to identify these patients early in their disease course so we can treat them more appropriately.” Mr. Seger and colleagues hypothesized that the balance between antitumor CD8-positive T cells and anti-inflammatory FoxP3-positive T cell regulatory cell infiltration in the initial cutaneous T-cell lymphoma biopsy would be predictive of disease progression. The cohort included 33 patients with cutaneous T-cell lymphoma (n=28 stage I, n=5 stage IIB). Median follow-up duration was 78 months. The cohort was divided into two groups depending on whether they developed progressive disease. They studied their skin biopsy specimens by multispectral immunofluorescence based on staining for CD4, CD8, FoxP3, programmed death 1, and DAPI expression. These examinations were followed by image deconvolution and automated cell analysis. Patients with greater CD8-positive T cell infiltration experienced significantly improved progres- sion-free survival in univariate (HR 0.6, CI 0.4–0.97, P = .04) and multivariate analysis (HR 0.4, CI 0.2–0.7, P = .01). When the team restricted the analysis to early-stage patients, this finding remained significant (HR 0.6, CI 0.4–0.98, P = .04) and did not correlate with malignant clone frequency or age.

Mr. Edward Seger

Dr. Pablo Augusto Vieyra-Garcia

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