The overlap of skin and blood T-cell clones in early-stage mycosis fungoides

Joffe, Daniel; Bhatti, Safiyyah; Banner, Lauren; Zaya, Romsin; Gleason, Laura; Mishra, Anjali; Kirsch, Ilan; Porcu, Pierluigi; Nikbakht, Neda

doi:10.1182/bloodadvances.2023010867

Cited by 1 publication

(6 citation statements)

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“…Of the studies that evaluated the relationship between dominant blood and skin clones, our group was the first to utilize HTS-TCR in a large cohort of early-stage MF patients. We found that patients with different, or ‘discordant’, dominant T-cell clones in blood and skin or no dominant blood clones had a longer time to systemic treatment compared to those with identical clones in blood and skin ( 58 ).…”

Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 91%

Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 99%

“…Several studies have explored the impact of blood T-cell clonality on prognosis ( 54 , 58 – 63 ). These studies have shown that the presence of a peripheral blood T-cell clone is linked to a less favorable prognosis, worse treatment response, and a shorter time to initiation of systemic treatment ( 54 , 58 – 63 ). However, the presence of a dominant peripheral blood T-cell clone alone may not be sufficient to predict prognosis and needs to be considered in the context of dominant skin T-cell clones.…”

Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 99%

“…Several groups began to interrogate the relationship between dominant blood and skin clones and their impact on prognosis using either PCR-electrophoresis, southern-blotting, or HTS-TCR assays. These studies show that when dominant T-cell clones in the blood match those in the skin, patients have a higher risk of disease progression and poor prognosis ( Table 4 ) ( 54 , 58 , 60 , 64 ). On the other hand, when dominant clones are present in both blood and skin but distinct from one another, prognosis is more favorable ( 58 , 60 ).…”

Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 99%

“…These studies show that when dominant T-cell clones in the blood match those in the skin, patients have a higher risk of disease progression and poor prognosis ( Table 4 ) ( 54 , 58 , 60 , 64 ). On the other hand, when dominant clones are present in both blood and skin but distinct from one another, prognosis is more favorable ( 58 , 60 ). Since HTS-TCR can identify the exact CDR3 sequences, it offers a more accurate means to establish whether dominant clones in blood and skin are truly identical.…”

Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 99%

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Immunosequencing applications in cutaneous T-cell lymphoma

Mandel,

Gleason,

Joffe

et al. 2023

Front. Immunol.

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Immunosequencing has emerged as a newer clinical test for assessment of T-cell clonality in the blood and skin of cutaneous T-cell lymphoma (CTCL) patients. Utilization of immunosequencing, also known as high-throughput sequencing of the T-cell receptor (HTS-TCR), enables identification and quantification of the precise genetic signature of dominant T-cell clones. Although immunosequencing is more sensitive than commonly used methods such as polymerase chain reaction (PCR) paired with capillary electrophoresis or flow cytometry, it remains underutilized for CTCL management. Nonetheless, incorporation of HTS-TCR in clinical practice offers distinct advantages compared to other molecular analyses that may improve diagnostic evaluation, prognostication, and disease monitoring in CTCL. The objective of this comprehensive review is to provide a thorough explanation of the application of immunosequencing in the context of CTCL. We describe the significance of T-cell clonality and the methods used to detect it, including a detailed comparison between PCR paired with capillary electrophoresis and HTS-TCR. The utilization of immunosequencing in the blood and skin of CTCL patients is discussed in depth, specifically outlining how HTS-TCR can assist in diagnosing CTCL, predicting outcomes, and tracking disease progression. Finally, we address the potential applications of immunosequencing in clinical management and research as well as the novel challenges it presents.

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Section: Utility Of Immunosequencing In Bloodmentioning

confidence: 91%