DIAGNOSTIC AND PROGNOSTIC-SIGNIFICANCE OF SEZARY CELLS IN PERIPHERAL-BLOOD SMEARS FROM PATIENTS WITH CUTANEOUS T-CELL LYMPHOMA

Google Scholar
  • 1 January 1985
    • journal article
    • research article
    • Vol. 66  (2) , 358-366
Abstract
Blood smears stained with Wright-Giemsa were obtained from 124 patients with pathologically confirmed cutaneous T cell lymphoma (CTCL), 70 patients with various other cutaneous disorders, and 10 healthy adult volunteers. These were examined in a blinded fashion for atypical lymphocytes with cerebriform nuclei (CL), which were characterized further according to cell diameter. CL comprising up to 15% of lymphocytes in smears, were observed in 20% of the patients with benign dermatitis. CL comprising up to 89% of lymphocytes in smears, were found in 22%, 30%, 50%, and 96% of patients with patch, plaque tumor and erythrodermic CTCL, respectively. Large-diameter C4 (15-20 .mu.m) were observed only in smears from patients with CTCL. Total CL counts above 15/100 lymphocytes and/or the presence of large CLs occurred in 33 of 49 (67%) patients with erythrodermic disease and in only 2 patients with other skin manifestations. Blood smears obtained at the time of cytogenetic studies indicated that a total CL count above 15% was the smear criterion that correlated best with the demonstration of a chromosomally abnormal malignant clone in the blood. The presence of large CL per se, although also predictive of a malignant clone, was less useful. Multivariate survival analysis showed that the duration of disease before the blood smear and the proportion of large CL within the total CL population were the covariates that correlated most significantly with survival. The reduced survival of patients with increased proportions of large CL in smears reflects the presence of polyploid malignant lymphocytes in the blood.