Unrelated immunodeficiency states may impact outcomes and immune checkpoint molecule expression in patients with mycosis fungoides: A clinicopathologic case-control study Journal Article
| Authors: | Warren, S.; Kheterpal, M.; Myskowski, P. L.; Moskowitz, A.; Horwitz, S. M.; Pulitzer, M. P. |
| Article Title: | Unrelated immunodeficiency states may impact outcomes and immune checkpoint molecule expression in patients with mycosis fungoides: A clinicopathologic case-control study |
| Abstract: | Background: Immunodeficiency (ID) correlates with worse outcomes and decreased immune checkpoint molecule expression in melanoma. The impact of ID in mycosis fungoides (MF) is unknown. Objective: Our goal was to evaluate the impact of ID in MF. Methods: We conducted a case-control study of 17 patients with MF and ID versus age-, stage-, and race-matched controls as a subset of a comparative analysis of 23 patients with MF with ID (prior lymphoma, recent/current pregnancy, HIV, hypogammaglobulinemia, and prior chemotherapy) versus without ID. Programmed cell death 1 (PD1), programmed death ligand 1 (PDL1), forkhead box p3, and interleukin 17 immunohistochemistry was performed on 12 patients with ID and 10 controls. Results: Patients with ID had more treatment failure (14 of 23 vs 5 of 17 [P =.028]), more treatment failure within 3 years of diagnosis (12 of 23 vs 4 of 17 [P =.050]), more angiocentrism (6 of 12 vs 0 of 10 [P =.005]), larger cells (1.92 ± 0.51 out of 3 vs 1.30 ± 0.48 out of 3 [P =.009]), more cases with at least 10% PD1 positivity (9 of 11 vs 4 of 10 [P =.031]) and at least 10% PDL1 positivity (7 of 12 vs 2 of 10 [P =.042]), and a higher average percentage of PD1+ cells (43.27 ± 40.22 vs 11.2 ± 13.62 [P =.028]). No differences in survival, forkhead box p3 expression, interleukin 17 expression, histologic depth, ulceration, granulomatous changes, or syringotropism were seen. Limitations: This was a small single-center study with heterogeneous immunodeficiencies. Conclusion: ID correlated with worse outcomes and increased PD1 and PDL1 expression in MF. Patients with MF and ID may be candidates for immune checkpoint inhibitor therapy, pending further investigation. © 2017 American Academy of Dermatology, Inc. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; middle aged; young adult; case control study; case-control studies; antineoplastic agent; forkhead transcription factors; metabolism; pathology; immunology; pregnancy; interleukin 17; interleukin-17; immune deficiency; immunocompromised host; forkhead transcription factor; mycosis fungoides; immunologic deficiency syndromes; foxp3 protein, human; immunosuppression; programmed death 1 ligand 1; programmed death 1 receptor; complication; peripheral tolerance; very elderly; humans; human; male; female; pdcd1 protein, human; programmed cell death 1 receptor; cd274 protein, human; b7-h1 antigen; programmed cell death 1 protein |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 78 |
| Issue: | 3 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2018-03-01 |
| Start Page: | 530 |
| End Page: | 539 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2017.09.015 |
| PUBMED: | 29132694 |
| PROVIDER: | scopus |
| PMCID: | PMC5815943 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 December 2018 -- Source: Scopus |
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