Outcome of extracorporeal photopheresis in mycosis fungoides patients is not predicted by quotients of systemic immune-inflammatory biomarkers

J Clin Apher. 2022 Aug;37(4):360-366. doi: 10.1002/jca.21982. Epub 2022 Mar 30.

Abstract

Background: Systemic immune-inflammatory biomarkers (SIIBs) have not been studied in mycosis fungoides (MF) patients undergoing extracorporeal photopheresis (ECP).

Objective: The objective was to determine whether recently proposed SIIBs are suitable to predict ECP treatment outcome and overall prognosis of patients with MF.

Methods: Twenty-nine MF patients were retrospectively evaluated who had undergone ECP. SIIBs included neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and pan-immune-inflammation value.

Results: Lymphocyte count (P = .021), CD4+/CD8+ cells (P = .00006), CD4+/CD56+ NK cells (P = .00008), and LDH levels (P = .0041) significantly declined after 6-month ECP. We could not detect significant cutoff values for baseline SIIBs capable of predicting advanced disease, overall response to 6-month ECP, or 5-year lymphoma-specific (LS) survival (P > .05). Circulating baseline counts of CD4+/CD7- cells (cutoff: ≤ 12.2; P = .010) and CD4+/CD26- cells (cutoff: ≤ 19.5; P < .0001) significantly predicted ECP treatment response after 6 months. Moreover, CD4+/CD8+ ratio (cutoff: > 1.34; P = .045) and increased thrombocyte counts (cutoff: >259 000; P = .010) were baseline predictors for 5-year LS death.

Conclusion: ECP appears to be beneficial in early-stage CTCL as well. Lower percentages of circulating CD4+/CD7- and CD4+/CD26- lymphocytes at baseline correlate with response to ECP. In this study, however, baseline SIIBs did not appear to serve as suitable biomarkers for the prediction of treatment outcome and LS survival.

MeSH terms

  • Biomarkers
  • Humans
  • Mycosis Fungoides* / therapy
  • Photopheresis*
  • Retrospective Studies
  • Skin Neoplasms* / therapy

Substances

  • Biomarkers