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

Lisa H. Shiue, Jacob Couturier, Dorothy E. Lewis, Caimiao Wei, Xiao Ni, Madeleine Duvic

Research output: Contribution to journalArticle

9 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)184-194
Number of pages11
JournalPhotodermatology Photoimmunology and Photomedicine
Volume31
Issue number4
DOIs
StatePublished - 2015

Keywords

  • CD25
  • CD8 T cells
  • Extracorporeal photopheresis
  • Foxp3
  • Mycosis fungoides
  • Regulatory T cells
  • Sézary syndrome

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Radiology Nuclear Medicine and imaging
  • Dermatology

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