Improved Sézary cell detection and novel insights into immunophenotypic and molecular heterogeneity in Sézary syndrome

Blood ◽  
2021 ◽  
Author(s):  
Safa Najidh ◽  
Cornelis P Tensen ◽  
Alita J. van der Sluijs-Gelling ◽  
Cristina Teodosio ◽  
Davy Cats ◽  
...  

Sézary syndrome (SS) is an aggressive leukemic form of Cutaneous T-cell Lymphoma with neoplastic CD4+ T cells present in skin, lymph nodes, and blood. Despite advances in therapy, prognosis remains poor with a 5-year overall survival of 30%. The immunophenotype of Sézary cells is diverse, which hampers efficient diagnosis, sensitive disease monitoring, and accurate assessment of treatment response. Comprehensive immunophenotypic profiling of Sézary cells with an in-depth analysis of maturation and functional subsets has not been performed thus far. We immunophenotypically profiled 24 SS patients employing standardized and sensitive EuroFlow-based multiparameter flow cytometry (MFC). We accurately identified and quantified Sézary cells in blood and performed an in-depth assessment of their phenotypic characteristics in comparison with their normal counterparts in the blood CD4+ T-cell compartment. We observed inter-and intra-patient heterogeneity and phenotypic changes over time. Sézary cells exhibited phenotypes corresponding with classical and non-classical T helper subsets with different maturation phenotypes.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2605-2605
Author(s):  
Ashley Ringrose ◽  
Youwen Zhou ◽  
Emily Pang ◽  
Ann E.-J. Lin ◽  
Xiao-Jiang Li ◽  
...  

Abstract Ahi-1 (Abelson helper integration site 1) is a novel gene that is commonly activated by provirus insertional mutagenesis in v-abl and myc-induced murine leukemias and lymphomas. It encodes a unique protein with SH3 and WD40-repeat domains suggesting novel signaling activities. Involvement of Ahi-1 in leukemogenesis is suggested by the high frequency of Ahi-1 mutations seen in certain virus-induced murine leukemias and lymphomas and by the gross perturbations seen in the expression of human AHI-1 and its isoforms in several human leukemia cell lines, particularly in the cutaneous T-cell leukemia cell lines, Hut 78 and Hut 102, where increases in AHI-1 transcripts of 40-fold are seen. To test directly whether the deregulated expression of AHI-1 in leukemic cells contributes to their transformed properties, knockdown of AHI-1 expression in Hut 78 cells, a cell line derived from peripheral blood of a patient with Sezary syndrome, was performed using retroviral-mediated RNA interference (RNAi). In a screen of 9 constructs that produce specific short hairpin AHI-1 transcripts, one was found to specifically inhibit AHI-1 expression in transduced Hut 78 cells by 80%, as evaluated by quantitative real-time RT-PCR, Northern and Western blot analyses. Retroviral-mediated suppression of AHI-1 also reduced the autocrine production of IL-2, IL-4 and TNFalpha in Hut 78 cells by up to 85% and caused a significant reduction in their growth factor independence in semi-solid cultures (up to 10-fold) and in single cell cultures (4-fold) by comparison to cells transduced with a control vector. Interestingly, although addition of IL-4, TNFalpha or a combination of 3 growth factors restored colony formation from the shRNA-transduced Hut 78 cells in semi-solid cultures, this was not achieved if only IL-2 was added, even though AHI-1 expression was inhibited. The ability of Hut 78 cells to produce tumors in NOD/SCID-β2microglobulin−/− mice within 3 weeks was also lost when AHI-1 expression was suppressed. Microarray analysis on RNA from Hut 78 cells with the suppression of AHI-1, using the Affymetrix Human Genome U133 plus 2.0 Arrays, identified differentially expressed molecules critical in T-cell activation, signal transduction, as well as cell proliferation and differentiation. Q-RT-PCR analysis revealed that the transcript levels of AHI-1 and its isoforms were significantly increased in CD4+CD7− Sezary cells, in which more than 85% of these cells are leukemic cells, in 5 of 6 blood samples obtained from patients with Sezary syndrome as compared to T cells similarly isolated from 8 healthy individuals. Elevated AHI-1 transcript levels were not found in 3 patient samples containing less than 35% leukemic Sezary cells. Taken together, these findings provide strong evidence of the oncogenic activity of AHI-1 in human T-cell leukemic cells and its deregulation can contribute to the development of human cutaneous T-cell lymphomas, including Sezary syndrome.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yuki Kageyama ◽  
Kenshiro Tsuda ◽  
Yuma Nato ◽  
Keiki Nagaharu ◽  
Kazutaka Suzuki ◽  
...  

Sézary syndrome is a rare leukemic type of cutaneous T-cell lymphoma characterized by the presence of neoplastic T cells with cerebriform nuclei (Sézary cells) in the skin, lymph nodes, and peripheral blood. Typical Sézary cells have a CD3+CD4+CD8– phenotype; however, in cases of the aberrant loss of antigens on Sézary cells, especially the loss of critically important T-cell antigens such as CD4, there is a possibility of misdiagnosing the disease or underestimating the tumor burden of the disease. Here, we report a rare case of Sézary syndrome with CD4/CD8 double-negative Sézary cells in the peripheral blood. Most of the Sézary cells in the peripheral blood had lost CD4 expression, and we diagnosed the disease and evaluated the tumor burden by multicolor flow cytometry. Intriguingly, the Sézary cells showed a typical CD4+CD8–CD7– phenotype in the skin even though the cells in the peripheral blood lacked CD4. The patient responded well to treatment with bexarotene and narrow-band ultraviolet B therapy. Analysis by multicolor flow cytometry is essential to diagnose this rare type of Sézary syndrome and evaluate the tumor burden.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2642-2642
Author(s):  
Francine M. Foss ◽  
Beth Higgins

Abstract Interleukin-2 (IL-2) has demonstrated activity as an antineoplastic and biomodulatory agent, but its activity in hematologic malignancies has not been fully defined. Cutaneous T-cell lymphoma (CTCL) has been characterized as a disorder of mature clonal CD4+CD7− cells with a predominantly Th2 cytokine profile and a blunted response to Th1 and Fas-associated apoptosis. Durable responses have been reported in several advanced CTCL patients in prior studies using high dose IL-2, but the capacity of IL-2 as an immune modulator to upregulate Th1 cytokine secretion and to facilitate a cytotoxic T-cell response in CTCL has not been studied. To further explore the activity of IL-2 to restore a Th1 phenotype and to induce an antitumor response in CTCL, we treated 11 patients with advanced or refractory CTCL with intermediate dose IL-2 (11 MIU subcutaneously daily x 4 days for 6 weeks with 2 weeks rest). The median age was 60 (range 55–72) among 6 females and 5 males. Disease was stage IB-IIA in 4, IIB in 2, III-IVB in 5, and 7 had circulating Sezary cells. Four had evidence of significant lymphadenopathy on CT scans. The mean prior therapies was 3, with 4 patients having received 3 or more systemic cytotoxic therapies. Five patients had prior electron beam irradiation, and 5 had prior biological therapies, including IFN in 3, bexarotene in 4, and interleukin-12 in one. The median cycles administered was 2 (range 1–8). Two patients were discontinued for toxicity, one with grade 3 constitutional symptoms and one who had severe underlying cardiovascular disease and developed bilateral lower extremity deep venous thromboses. Overall, therapy was well tolerated with grade 3 fatigue in 3 patients and grade 2 eosinophilia in one. Response data includes: 4 patients with partial response, including 3 with Sezary syndrome and one with diffuse plaque stage disease; 3 patients with stable disease; 2 patients with progressive disease; 2 patients discontinued before completing one cycle and were inevaluable for response. One patient with diffuse pruritis, erythroderma and circulating Sezary cells completed 8 cycles of therapy and had a complete response in the skin but persistence of a low number of Sezary cells in the blood. Immunophenotypic analysis of circulating lymphocytes revealed an overall increase in CD4+CD25+ cells during therapy, suggesting a direct immunomodulatory effect of IL-2. In summary, our experience with intermediate dose IL-2 demonstrates that the therapy was well tolerated and was associated with biological activity in patients with extensive and refractory CTCL, with responses noted in 3 of 7 patients with Sezary syndrome. Based on our results, we intent to explore the biomodulatory effects of IL-2 on both normal T-cells and Sezary cells to attempt to define the role of IL-2 as a single agent or in combination with other biological agents in patients with CTCL.


Blood ◽  
1990 ◽  
Vol 76 (11) ◽  
pp. 2343-2347 ◽  
Author(s):  
SJ Pirruccello ◽  
MS Lang

Abstract In the hematopoietic system, the B-cell associated antigen CD24 is expressed at high density on B cells, B-cell precursors, and B-cell malignancies as well as at low density on peripheral blood polymorphonuclear leukocytes. The 42-Kd sialoglycoprotein has not been previously demonstrated to be expressed on T cells, thymocytes, or T- cell malignancies. We identified three patients with mycosis fungoides/Sezary syndrome that showed low density expression of the CD24-related epitope recognized by antibody BA-1 on circulating T cells. All three patients had Sezary cells by morphologic assessment and clonal T-cell populations in the peripheral blood by gene rearrangement studies. In two of these patients, indirect immunofluorescence with a panel of six anti-CD24 monoclonal antibodies demonstrated reactivity for two of six antibodies in one case and only one of six antibodies in the other. The biologic significance of CD24- related epitope expression on circulating T cells in mycosis fungoides/Sezary syndrome is unclear. However, these findings suggest that differential, low density expression of CD24-related epitopes (BA- 1+, OKB2-) may be a useful phenotypic marker for identifying circulating Sezary cells.


2021 ◽  
Vol 156 ◽  
pp. S6
Author(s):  
Safa Najidh ◽  
Cornelis P. Tensen ◽  
Alita J. van der Sluijs-Gelling ◽  
Cristina Teodosio ◽  
Davy Cats ◽  
...  

Blood ◽  
1990 ◽  
Vol 76 (11) ◽  
pp. 2343-2347
Author(s):  
SJ Pirruccello ◽  
MS Lang

In the hematopoietic system, the B-cell associated antigen CD24 is expressed at high density on B cells, B-cell precursors, and B-cell malignancies as well as at low density on peripheral blood polymorphonuclear leukocytes. The 42-Kd sialoglycoprotein has not been previously demonstrated to be expressed on T cells, thymocytes, or T- cell malignancies. We identified three patients with mycosis fungoides/Sezary syndrome that showed low density expression of the CD24-related epitope recognized by antibody BA-1 on circulating T cells. All three patients had Sezary cells by morphologic assessment and clonal T-cell populations in the peripheral blood by gene rearrangement studies. In two of these patients, indirect immunofluorescence with a panel of six anti-CD24 monoclonal antibodies demonstrated reactivity for two of six antibodies in one case and only one of six antibodies in the other. The biologic significance of CD24- related epitope expression on circulating T cells in mycosis fungoides/Sezary syndrome is unclear. However, these findings suggest that differential, low density expression of CD24-related epitopes (BA- 1+, OKB2-) may be a useful phenotypic marker for identifying circulating Sezary cells.


2004 ◽  
Vol 112 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Arnaud Cirée ◽  
Laurence Michel ◽  
Sophie Camilleri-Bröet ◽  
Francette Jean Louis ◽  
Michèle Oster ◽  
...  

2015 ◽  
Vol 135 (1) ◽  
pp. 229-237 ◽  
Author(s):  
Bouchra Ghazi ◽  
Nicolas Thonnart ◽  
Martine Bagot ◽  
Armand Bensussan ◽  
Anne Marie-Cardine

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