The effect of extracorporeal photopheresis alone or in combination therapy on circulating CD4(+) Foxp3(+) CD25(-) T cells in patients with leukemic cutaneous T-cell lymphoma.

Abstract

PURPOSE:

Extracorporeal photopheresis (ECP) alone or in combination therapy is effective for treatment of leukemic cutaneous T-cell lymphoma (L-CTCL), but its mechanism(s) of action remain unclear. This study was designed to investigate the effect of ECP on regulatory T cells and CD8(+) T cells in L-CTCL patients.

EXPERIMENTAL DESIGN:

Peripheral blood from 18 L-CTCL patients at baseline, Day 2, 1 month, 3 month, and 6 month post-ECP therapy was analyzed by flow cytometry for CD4(+) CD25(+/high) , CD4(+) Foxp3(+) CD25(+/-) , CD3(+) CD8(+) , CD3(+) CD8(+) CD69(+) , and CD3(+) CD8(+) IFN-γ(+) T cells. Clinical responses were assessed and correlated with changes in these T-cell subsets.

RESULTS:

Twelve of 18 patients achieved clinical responses. The average baseline number of CD4(+) CD25(+/high) T cells of PBMCs in L-CTCL patients was normal (2.2%), but increased at 6-month post-therapy (4.3%, P < 0.01). The average baseline number of CD4(+) Foxp3(+) T cells out of CD4(+) T cells in nine evaluable patients was high (66.8 ± 13.7%), mostly CD25 negative. The levels of CD4(+) Foxp3(+) T cells in responders were higher (n = 6, 93.1 ± 5.7%) than nonresponders (n = 3, 14.2 ± 16.0%, P < 0.01), and they declined in parallel with malignant T cells. The numbers of CD3(+) CD8(+) CD69(+) and CD3(+) CD8(+) IFN-γ(+) T cells increased at 3-month post-therapy in five of six patients studied.

CONCLUSIONS:

Extracorporeal photopheresis alone or in combination therapy might be effective in L-CTCL patients whose malignant T cells have a CD4(+) Foxp3(+) CD25(-) phenotype.

• Authors: Lisa H Shiue, Jacob Couturier, Dorothy E Lewis, Caimiao Wei, Xiao Ni, Madeleine Duvic
• Journal: Photodermatology, photoimmunology & photomedicine (Photodermatol Photoimmunol Photomed) Vol. 31 Issue 4 Pg. 184-94 (Jul 2015) ISSN: 1600-0781 [Electronic] England
• PMID: 25772268 (Publication Type: Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antigens, CD
• IFNG protein, human
• Interferon-gamma

Topics

• Aged
• Antigens, CD (immunology)
• CD8-Positive T-Lymphocytes (immunology, pathology)
• Combined Modality Therapy
• Humans
• Interferon-gamma (immunology)
• Lymphoma, T-Cell, Cutaneous (immunology, pathology, therapy)
• Male
• Middle Aged
• Photopheresis
• Retrospective Studies
• T-Lymphocytes, Regulatory (immunology, pathology)