Duygu GÜLSEREN, Ecem BOSTAN, Sibel DOĞAN, Başak Yalıc ARMAĞAN, Neslihan AKDOĞAN, Sibel ERSOY EVANS, Gonca ELÇİN, Ayşen KARADUMAN, Nilgün ATAKAN

Lactate Dehydrogenase, Beta-2 Microglobulin Levels and CD4/CD8 Lymphocyte Ratio in Patients with Mycosis Fungoides in Stage 1A

Objective: Mycosis fungoides is the most common type of primary cutaneous T-cell lymphomas. In this study, we aimed to investigate the biochemical parameters of beta-2 microglobulin, lactate dehydrogenase, CD4/CD8 lymphocyte ratio determined by flow cytometry, and T cell clonality in patients with MF and to correlate these parameters in stage 1A and other stages. Materials and Methods: A hundred sixty-one (87 Male, 74 Female) patients followed-up between January 1995 and January 2019 were retrospectively evaluated. Patients’ demographics, stage of the disease, peripheral lymph node and organ involvement, peripheral blood beta2-microglobulin, lactate dehydrogenase levels, CD4/CD8 + lymphocyte ratio and presence of T cell clonality in biopsy samples were evaluated. Results: Median beta-2 microglobulin levels were 1608.5 ng/ml for stage 1A and 1970.5 ng/ml for other stages. Peripheral blood median CD4/ CD8 lymphocte ratio was 1.60 for stage 1A and 1.85 for other stages. We found statistically significant difference between two groups in terms of beta-2 microglobulin levels and peripheral blood median CD4/CD8 lymphocte ratio (p=0.001, p=0.04). No statistically significant difference was found between two groups in terms of lactate dehydrogenase levels and T-cell clonality (p=0.234, p=0.525). Conclusion: Our study supports that high peripheral blood beta-2 microglobulin level and CD4/CD8 lymphocyte ratio at the time of diagnosis may imply advanced stage and poor prognosis in Mycosis Fungoides.

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[1] Girardi M, Heald PW, Wilson LD. The pathogenesis of mycosis fungoides. N Engl J Med. 2004; 350: 1978-88.

[2] Amorim GM, Niemeyer-Corbellini JP, Quintella DC, et al. Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol. 2018; 93: 546- 52.

[3] Terragni R, Morselli-Labate A, Massimo Vignolİ M, et al. Is Serum Total LDH Evaluation Able to Differentiate between Alimentary Lymphoma and Inflammatory Bowel Disease in a Real World Clinical Setting? PLoS One. 2016; 11: e0151641

[4] Bento L, Díaz-López A, Barranco G, et al. New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO). Br J Haematol. 2020; 188: 888-97.

[5] An Y, Jiang W, Andraos TY, et al. Multi-institutional Investigation: Circulating CD4:CD8 ratio is a prognosticator of response to total skin electron beam radiation in mycosis fungoides. Radiother Oncol. 2019; 131: 88-92

[6] Massone C, Crisman G, Kerl H, et al. The prognosis of earlymycosis fungoides is not influenced by phenotype and T-cell clon-ality. Br J Dermatol 2008; 159: 881-6.

[7] Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007; 110: 1713-22.

[8] Güssow D, Rein R, Ginjaar I, et al. The human beta 2-microglobulin gene. Primary structure and definition of the transcriptional unit. J Immunol. 1987; 139: 3132-8.

[9] Chen ZH, Qiu MZ, Wu XY, et al. Elevated baseline serum lactate dehydrogenase indicates a poor prognosis in primary duodenum adenocarcinoma patients. J Cancer. 2018; 9: 512-20.

[10] Saif FA. Prognostic Significance of Serum Lactate Dehydrogenase in Saudi Patients with Mycosis Fungoides: A Retrospective Study of 47 Patients. J Clin Exp Dermatol Res. 2016; 7: 2.

[11] Jiang, W, Abou Yehia, Z, Dabaja B, et al. CD4:CD8 Ratio in Mycosis Fungoides: Prognostic and Predictive Value of Circulating T Lymphocyte Subsets for Outcomes After Total Skin Electron Beam Radiation. International Journal of Radiation Oncology, Biology, Physics. 2016; 96: S20.

[12] Xu C, Wan C, Wang L, et al. Diagnostic significance of TCR gene clonal rearrangement analysis in early mycosis fungoides. Chin J Cancer. 2011; 30: 264-72.

[13] Acikalin A, Bagir E, Tuncer I, et al. Contribution of T-cell receptor gamma gene rearrangement by polymerase chain reaction and immunohistochemistry to the histological diagnosis of early mycosis fungoides. Saudi Med J. 2013; 34: 19-23.