Blood classification and blood response criteria in mycosis fungoides and SEzary syndrome using flow cytometry: recommendations from the EORTC cutaneous lymphoma task force
Abstract Our current mycosis fungoides (MF) and SEzary Syndrome (SS) staging system includes blood-classification from B0-B2 for patch/plaque/tumour or erythroderma based on manual SEzary counts but results from our EORTC survey confirm these are rarely performed in patch/plaque/tumour MF, and there is a trend towards using flow cytometry to measure blood-class. Accurately assigning blood-class effects overall stage and the ‘global response’ used to measure treatment responses in MF/SS and hence impacts management. The EORTC Cutaneous Lymphoma Task Force Committee have reviewed the literature and held a Workshop (June 2017) to agree a definition of blood-class according to flow cytometry. No large study comparing blood-class as defined by SEzary count with flow cytometry has been performed in MF/SS. The definition of blood-class by flow cytometry varies between publications. Low-level blood involvement occurs in patch/plaque/tumour much less than erythroderma (p For consistency flow, definition for blood-class must be an objective measurement. We propose absolute counts of either CD4+CD7-or CD4+CD26-where B0 Highlights Blood-class was introduced into staging of MF/SS in 2007 using manual Sezary counts which are rarely performed in all stages. Flow cytometry has largely replaced manual Sezary counts for monitoring blood involvement in MF/SS. Flow cytometry should define blood class according to absolute counts of CD4+7- or CD4+26- populations. Clinical significance of variation in blood-class between B0/B1 has not been proven and should not be considered in response criteria.
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