Peripheral blood involvement in a mycosis fungoides patient with limited skin lesions: phenotypical features and homing molecule pattern

Peripheral blood involvement in mycosis fungoides (MF) patients is more fre quent in the advanced stages and is associated with a worse prognosis. We r eport a MF patient with limited patch lesions on her shoulders, upper chest and thighs (T2N0M0) and peripheral blood involvement. Clonality in the per ipheral blood was demonstrated by the PCR assay and confirmed by the expans ion of the same restricted variable region of the TCR beta -chain (v beta 1 7) expressed in the cutaneous infiltrate. The patient was treated with flud arabine achieving a complete hematological response followed by an early re lapse. whilst the cutaneous lesions remained unchanged. The soluble interle ukin-2 receptor levels showed a decrease from baseline levels down to norma l values at hematological remission, followed by a further increase. The lo w sLe(x)/CLA expression in the cutaneous lymphoid infiltrate could have giv en rise to a higher recruitment in the peripheral blood.