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PubMed1981

Mycosis fungoides: diagnostic criteria based on quantitative electron microscopy.

Quantitative electron microscopy can provide objective measurements of nuclear atypia in lymphoid cells in skin biopsies during early stages of infiltration of the skin as part of inflammatory or neoplastic processes. This potentially provides a method for establishing reproducible criteria for determining whether an individual skin biopsy represents mycosis fungoides or is unlikely to represent mycosis fungoides. To investigate such criteria, quantitative electron microscopic studies of skin biopsies from 109 patients were performed. Seventy-seven patients had benign disorders, 16 patients had early mycosis fungoides, and 16 patients had controversial lesions. Measurements were made of lymphocyte nuclear profile perimeter and areas in electron micrographs. A nuclear contour index was calculated. On the basis of the mean degree of nuclear convolution alone, mycosis fungoides was not adequately distinguished from benign disorders. Better discrimination was achieved when the proportion of cells with a anuclear contour index of 9.0 or more was considered as an additional actor. When statistical methods were used to select discriminating factors, the best electron microscopic discrimination between benign and mycosis fungoides groups occurred when the proportion of cells with a nuclear contour index of 7 or more and the proportion of cells with a nuclear profile area greater than 30 sq. micrometer. were used together. Nomograms are presented which demonstrate the use of these criteria for a given case.

Aged↗
PubMed1995

Mycosis fungoides palmaris et plantaris.

BACKGROUND: Mycosis fungoides primarily localized to the palms and soles is rare and has been previously reported as cutaneous lymphoma in four patients or as Woringer-Kolopp disease in eight patients. OBSERVATIONS: Four patients were initially diagnosed and treated unsuccessfully for various palmoplantar dermatitides until histopathologic findings revealed mycosis fungoides. Each case exhibited a clonal rearrangement of T-cell receptor gamma genes and immunohistochemical studies consonant with mycosis fungoides. All patients had limited skin involvement without evidence of extracutaneous involvement. CONCLUSIONS: Mycosis fungoides palmaris et plantaris is an uncommon expression of mycosis fungoides that manifests primarily on the palms and soles and clinically may mimic various inflammatory palmoplantar dermatoses. A biopsy is recommended in the evaluation of recalcitrant palmoplantar dermatoses.

Diagnosis, Differential↗
PubMed1994

Hypopigmented mycosis fungoides.

BACKGROUND: Only five cases of purely macular hypopigmented mycosis fungoides have been published in the literature. These patients all had clinical evidence of disease 7 months to 10 years prior to histologic diagnosis, suggesting that this clinical presentation of mycosis fungoides is easily misdiagnosed. OBSERVATIONS: Three African-American males, ages 9, 15, and 22 years, were found to have mycosis fungoides on evaluation of skin biopsy specimens after initially being clinically diagnosed with, and treated for, pityriasis alba. All three had typical histopathologic changes and cell marker studies showing a relative loss of the CD7 antigen, which is normally present on the majority of T cells. One patient who was treated with methoxsalen plus UV light (PUVA) therapy had clearance of his disease clinically and histologically. CONCLUSION: From the literature, it would appear that macular hypopigmented mycosis fungoides is exceptionally rare. This perceived rarity may be inaccurate due to either relative underreporting, incorrect diagnoses, or both. From the eight patients now reported to date, it may be said that hypopigmented mycosis fungoides may be seen in nonwhite individuals and more often than not, has onset before age 20 years.

Adolescent↗
PubMed1996

Clinical stage IA (limited patch and plaque) mycosis fungoides. A long-term outcome analysis.

OBJECTIVES: To study the long-term results of treatment of patients with stage IA mycosis fungoides and analyze the factors related to disease progression and the effect of initial therapy on survival and freedom from relapse. DESIGN: A single-center, 32(1/2)-year, retrospective cohort analysis. SETTING: Private referral medical center. PATIENTS: One hundred twenty-two patients with clinical stage IA (T1, N0, M0) mycosis fungoides. MAIN OUTCOME MEASURES: Long-term actuarial survival and freedom-from-relapse results as calculated by the technique of Kaplan-Meier. RESULTS: The long-term (30-year) survival of patients with stage IA mycosis fungoides is similar to the expected survival of a race-, age-, and sex-matched control population. The median survival of this group has not been reached at 32(1/2)-years. Eleven patients (9%) who progressed to more advanced disease had a lower complete response rate to initial therapy than did other patients (36% vs 82%) and an older mean age than did other patients with T1 disease (61 vs 48 years, P < .05). Only 3 (2%) of 122 patients died of disease. Among stage IA patients who achieved a complete response, 25% are relapse free at 10 years. Patients who received total skin electron beam therapy (n = 34) had a more favorable freedom-from-relapse outcome than those treated with topical mechlorethamine hydrochloride (nitrogen mustard) (n = 73, P < .05). No significant difference was seen in the long-term survival between the 2 treatment groups. CONCLUSIONS: Patients with clinical stage IA mycosis fungoides treated at Stanford University do not have an altered life expectancy. Fewer than 10% progressed to more advanced stages and few died of disease. Although the response rate to total skin electron beam therapy was superior to that of topical mechlorethamine, the longterm survival results were similar. Topical mechlorethamine is a cost-effective and convenient therapy for patients with limited patch and plaque mycosis fungoides.

Actuarial Analysis↗
PubMed1997

[Unilesional plaque-type mycosis fungoides: 3 cases].

BACKGROUND: The clinical course of unilesional plaques with a histological diagnosis of mycosis fungoides is generally benign. This uncommon situation raises the question of nosology among epidermotropic T-cell proliferations. CASE REPORT: Two women (age 65 and 70 years, cases 1 and 2) and one man (age 66 years, case 3) each had a well-limited unique oval-shaped plaque measuring 1 to 3 cm in diameter for several months. The localization of the erythematous, squamous plaques with minimal infiltration and little or no pruritus remained unchanged in the dorsal area. Histology reported mycosis fungoides: dense superficial dermal infiltration in band attached to the epidermis with a clear lower limit, formed by small and medium-sized atypical lymphocytes, sometimes with cerebriform nuclei. Epidermotropism on isolated cells or theques was noted. There was no spongiosis. Immunolabeling demonstrated predominance of CD4+ cells and tumoral infiltration uptake of anti-V beta 8 monoclonal antibodies in the two cases examined. The lesion totally regressed in case 1 after local application of carmustine with no recurrence after 5 years. Patient 2 declined treatment and no change was observed 5 years later. Surgical exeresis was performed in case 3 without recurrence 3 years later. DISCUSSION: No histological feature or T-cell immunophenotype distinguishes this clinical entity from classical mycosis fungoides. As no other long-term lesions developed, our three cases would argue for a benign course of what is probably a variety of mycosis fungoides. Unilesional plaque mycosis fungoides must be lymphomatoid contact dermatitis. Woringer-Kolopp disease differs by its nearly exclusive epidermotropic distribution.

Aged↗
PubMed1997

Epidemiology of invasive mycosis in ICU patients: a prospective multicenter study in 435 non-neutropenic patients. Paul-Ehrlich Society for Chemotherapy, Divisions of Mycology and Pneumonia Research.

OBJECTIVE: To determine the epidemiological and clinical significance of invasive fungal infections in non-neutropenic patients in intensive care who stay longer than 10 days on the intensive care unit (ICU). DESIGN: Prospective epidemiological multicenter study over a period of 11 months, based on strict clinical, bacteriological, serological and histological criteria. SETTING: Six surgical and two medical ICUs units in five university and two municipal hospitals. PATIENTS: 435 non-neutropenic patients from medical and surgical ICUs with an ICU stay of more than 10 days. MEASUREMENTS AND MAIN RESULTS: A new occurrence of invasive mycosis (3 sepsis/4 peritonitis/1 disseminated candidiasis), corresponding to the protocol conditions with onset after day 10 in the ICU, was detectable in 2.0% (95% confidence interval 0.85 to 3.8%) of the 409 patients who could be assessed. Candida species were identified as an infection-relevant pathogen in all cases. The most important risk factor for the development of an invasive mycosis was the onset of peritonitis by the day 11 in the ICU (odds ratio 11.3; p = 0.003). A fungal colonization was detected in 64% of patients (Candida species 56%, Aspergillus 4%, and other fungi). Six of 8 patients with an invasive mycosis died on the ICU; ICU mortality in patients with fungal colonization was 31% and in noncolonized patients 26%. Serological tests were not helpful clinically. The sensitivity was 88% for the Candida HAT (haemagglutination test) (threshold titer > 1:160), 100% for the Candida IFT (immunofluorescence test) (threshold titer > 1:80), and 50% for the Candida Antigen Test (Candtec Ramco, threshold titer > or = 1:8), and the specificity was 26, 6, and 73%, respectively. The specificity for the Aspergillus HAT (threshold titer > 1:10) was 29%. CONCLUSIONS: Invasive mycoses are rare in non-neutropenic ICU patients, even after a longer stay in the intensive care unit; fungal colonization, on the other hand, is frequently detectable. The mortality of invasive mycosis--even with systemic antimycotic therapy--was high; the mortality in patients with fungal colonization was not significantly increased compared to that in noncolonized patients. The serological test procedures, Candida HAT, Candida IFT, and the Candida Ramco Antigen Test, had a low specificity and were not helpful in diagnosing relevant invasive mycosis.

Adolescent↗
PubMed2004

Safety and efficacy of caspofungin and liposomal amphotericin B, followed by voriconazole in young patients affected by refractory invasive mycosis.

OBJECTIVE: Data on the use of combination of liposomal amphotericin B and caspofungin followed by voriconazole, as maintenance or further rescue treatment, in 10 patients with invasive mycosis are reported. MATERIAL AND METHODS: The diagnoses were acute leukemia (7), myelodysplastic syndrome (1) and Hodgkin's lymphoma (1). All patients developed an invasive mycosis (proven, 3; probable, 6; and possible, 1) refractory to first-line antifungal treatment (liposomal amphotericin B in all patients except one who received fluconazole). RESULTS: Rescue therapy with a combination of caspofungin and liposomal amphotericin B was well tolerated, hypokalemia, and thrombophlebitis being the most common side-effects. Combination therapy was administered for a median of 17 d, range 6-40. Among the nine patients with proven or probable mycosis, one was not evaluated because of early death caused by massive hemoptysis whilst in the remaining eight patients, the response was classified as complete, stable and failure in four, three, and one patients, respectively. Complete response was also observed in patient with possible mycosis. Eight of nine patients received voriconazole for a median of 75 d, range 42-194. Voriconazole was well tolerated although some drug interactions were observed during treatment with methotrexate and digoxin. After a median follow-up of 125 d, nine of 10 patients are alive. Overall, a favorable response to antifungal treatment (including the case of possible mycosis) was obtained in eight of 10 patients. CONCLUSION: These data suggest that medical antifungal treatment may be intensified in severely ill patients without significantly compromising patient safety. The combination of synergistic antifungal drugs as well as their sequential use warrants further investigation by a larger randomized controlled study.

Adolescent↗
PubMed1982

[A pathological study on cerebral mycosis].

The histopathological examination was performed in search of cerebral mycosis in autopsy cases at our department during the 6 years from 1976 to 1981. The cerebral mycoses were histopathologically verified in seven cases, although brain tissue was examined in only 46% of 528 autopsy cases. All cases of cerebral mycosis showed underlying diseases which were hematologic diseases (5 cases), SLE (1 case), and myocardial infarction with indwelling deep venous lines (1 case). Among these cerebral mycosis, one had double fungal infections with aspergillus and candida, while others were as follows; aspergillosis (2 cases), mucormycosis (2 cases), candidiasis (1 case) and cryptococcosis (1 case). Six cases were not diagnosed antemortem with exception of a case of cryptococcosis. Systemic fungal infections were seen in six cases, however, a case of mucormycosis was without systemic infection. Each cerebral mycosis showed its own characteristic histopathologic findings, namely, hemorrhagic and necrotic lesions in aspergillosis and mucormycosis, scattered minute abscesses or granulomatous lesions in candidiasis, and gelatinous lesions in leptomeninges in cryptococcosis. Severe lymphocytopenia (less than 500/mm3) was always present in all except a case of rhinocerebral mucormycosis. It is emphasized that cerebral mycosis should be always considered when neurological symptoms were clinically observed in patients who had severe underlying diseases and/or deep venous lines with severe lymphocytopenia.

Adolescent↗
PubMed1998

Analysis of T-cell receptor gene rearrangement in lymph nodes of patients with mycosis fungoides. Prognostic implications.

OBJECTIVE: To determine the prognostic value of analyzing lymph node (LN) DNA from patients with mycosis fungoides for the presence of a monoclonal T-cell population. DESIGN: Inception cohort study. SETTING: A tertiary care referral center in Seattle, Wash. PATIENTS: Fifty-five uniformly staged patients with the diagnosis of mycosis fungoides and who had a lymph node biopsy, 21 with clinically abnormal nodes and 34 with normal nodes. MAIN OUTCOME MEASURES: Lymph nodes were evaluated by Southern blot analysis for T-cell receptor beta-chain (TCRB) gene rearrangement and by histopathologic examination for the LN classification using the National Cancer Institute system. Patients were observed clinically for a mean (+/- SD) of 4.7 +/- 3.4 years. RESULTS: Patients with detectable TCRB gene rearrangement in lymph node DNA had an increased likelihood of a poor clinical outcome and a decreased probability of survival (P < .001 for both) compared with patients with the TCRB germline. Although patients with clinically enlarged nodes were more likely to have the TCRB gene rearranged, those with normal nodes and the TCRB gene rearranged also had a poor clinical outcome and a decreased probability of survival. Similar to those with the TCRB gene rearranged, most patients with advanced histopathologic changes (LN3 and LN4) had a poor prognosis. The presence of a rearranged TCRB gene, however, correctly predicted some patients with intermediate LN scores (LN2) who had a poor clinical outcome. CONCLUSIONS: Detection of a monoclonal T-cell population, as demonstrated by a rearranged TCRB gene on Southern blot analysis, in LNs of patients with mycosis fungoides is predictive of a poor clinical outcome and a reduced probability of survival. Lymph node TCRB gene analysis provides additional prognostic information for patients with mycosis fungoides with intermediate LN histopathology.

Antineoplastic Agents↗
PubMed1999

Clinical characteristics and long-term outcome of patients with generalized patch and/or plaque (T2) mycosis fungoides.

OBJECTIVES: To study the long-term results of treatment of patients with generalized patch and/or plaque mycosis fungoides and to identify clinical characteristics predictive of survival and response to treatment. DESIGN: A single-center, 35.5-year retrospective cohort analysis. SETTING: Private referral medical center. PATIENTS: One hundred seventy-six patients with generalized patch and/or plaque (T2) mycosis fungoides. MAIN OUTCOME MEASURES: Long-term actuarial survival and freedom-from-relapse results as calculated by the Kaplan-Meier method. RESULTS: The long-term (35.5-year) survival of patients with T2 mycosis fungoides is worse than the expected survival of a race-, age-, and sex-matched control population (P<.001). The median survival of the T2 group is 11.7 years. Patients younger than 58 years (median age) at presentation have a more favorable overall and disease-specific survival than the patients who are 58 years or older (P<.001 vs P<.025). Patient sex or race had no significant effect on overall survival. Patients who presented with palpable clinically significant lymph nodes (stage IIA) had long-term survival results similar to those without lymphadenopathy (stage IB), despite improved freedom-from-relapse outcome for patients with stage IB. Twenty-four percent of patients who progressed to more advanced disease had a lower complete response rate to initial therapy than did other patients (21% vs 65%) (P<.001). Patients who received total skin electron beam therapy had a better complete response rate than patients treated with topical mechlorethamine hydrochloride alone; the relapse-free results were superior in patients with a total dose of 30 Gy or higher and in patients who received topical mechlorethamine as adjuvant therapy following total skin electron beam therapy. Despite differences in freedom-from-relapse results among different treatment groups, long-term overall or disease-specific survivals were not significantly different. CONCLUSIONS: A significant proportion (24%) of patients with generalized patch and/or plaque (T2) mycosis fungoides experience disease progression to a more advanced clinical stage, and nearly 20% eventually die of the disease. Younger patients have a more favorable disease-specific long-term outcome than patients who are older. Presence of lymphadenopathy (stage IIA) at diagnosis does not predict worse long-term survival outcome. Clinical features predictive of disease progression include initial lymphadenopathy (stage IIA) and lack of complete response to initial treatment. Despite superior complete response rate to a 30-Gy or higher dose of total skin electron beam therapy, topical mechlorethamine proves to be a cost-effective initial treatment for patients with T2 disease. The concept of an adjuvant therapy after irradiation is appealing, although it may not lead to improved long-term survival.

Adult↗
PubMed1991

Mycosis fungoides metastatic to the orbit.

We report a case of mycosis fungoides metastatic to the anterior orbit in an 83-year-old woman. The patient had a history of several years' duration of well-controlled primary mycosis fungoides with localized dermatologic T-cell lymphomas, mainly on the lower extremities. She developed gradual proptosis, hyperophthalmos, and vertical diplopia. Computed tomography demonstrated a solid, extraconal mass in the right lower anterior orbit. Biopsy revealed a gristly, yellowish, infiltrating mass at the level of the inferior orbital septum. Pathologic examination revealed anaplastic T lymphocytes with multiloculated, cerebriform nuclei that matched those of the primary mycosis fungoides skin tumors. Mycosis fungoides rarely spreads to the ocular and periocular structures, and this case was unique in that it presented as a pure orbital lesion with sparing of the overlying lids and adnexal structures.

Aged↗
PubMed1992

Mycosis fungoides of the larynx. Report of two cases and review of the literature.

Involvement of the larynx by mycosis fungoides is extremely rare with only three reported clinical cases in the English-language literature. We present two patients with laryngeal mycosis fungoides, one of whom presented with vocal cord paresis (progressing to paralysis) as the initial clinical manifestation of laryngeal involvement. Our clinical findings and the observations from the three previous case reports suggest that laryngeal mycosis fungoides has a predilection for the arytenoids, aryepiglottic folds, and the laryngeal surface of the epiglottis. Laryngeal involvement, like other forms of visceral dissemination, appears to manifest clinically in the terminal stages of the disease. The natural history, clinical features, histopathology, and treatment of mycosis fungoides are reviewed and the etiopathology of the vocal cord paralysis is described.

Aged↗
PubMed1999

Total skin electron radiation for patients with erythrodermic cutaneous T-cell lymphoma (mycosis fungoides and the Sézary syndrome).

BACKGROUND: There is limited published evidence regarding the efficacy of total skin electron beam radiation for patients with the diffuse erythrodermic form of mycosis fungoides. METHODS: Forty-five patients with erythrodermic mycosis fungoides were managed at McMaster University in Hamilton, Ontario, Canada (n=34), and at Yale University (n=11) between 1970 and 1996. All received radiation without neoadjuvant, concomitant, or adjuvant therapies. The median age was 67 years (range, 42-84 years). The male-to-female ratio was 2.2. Fifteen received radiation for the treatment of newly diagnosed disease. There were 28 with Stage III (T4 N0-1 M0), 13 with Stage IVA (T4 N2-3 M0), and 4 with Stage IVB (T4 N0-3 M1) disease, and 21 had blood involvement. The median radiation dose was 32 gray (Gy) (range, 4.8-40 Gy). The median treatment time was 21 days (range, 3-125 days). A technically more intense method of radiation (32-40 Gy and 4-6 MeV electrons) was administered to 23 patients. RESULTS: All patients responded. The rate of complete cutaneous remission was 60%, with 26% remaining progression free at 5 years. Remission was associated with more intense radiation (P=0.014 in multivariate analysis with adjustment for blood and staging information). With the more intense radiation, 74% attained remission, with 36% remaining progression free at 5 years. For 8 patients with Stage III disease without blood involvement, all entered remission, with 69% remaining progression free at 5 years. Twenty of 30 deaths were related to mycosis fungoides. The median overall survival was 3.4 years, with a 10-year estimate of 28%. The median cause specific survival was 5 years, with a 10-year estimate of 43%. Both overall and cause specific survival were associated with an absence of blood involvement (both P<0.03 in multivariate analysis). Age was not a significant factor. Toxicities of radiation were acceptable when radiation was administered over 6-9 weeks at 5 fractions per week. CONCLUSIONS: Total skin radiation is an efficient monotherapy for patients with erythrodermic mycosis fungoides. With more intense radiation, the rate of cutaneous remission is 74%, and 27% remain progression free at 10 years. Radiation may be most efficacious in Stage III, with no blood involvement. When there is blood, lymph node, or visceral involvement, combined modality therapies should be explored.

Adult↗
PubMed1976

Leptomeningeal mycosis fungoides.

Central nervous system involvement with mycosis fungoides complicated the clinical course of a patient at a time when his skin was clinically free of disease following systemic chemotherapy. A leptomeningeal syndrome of blurred vision and papilledema, and confusion progressing to coma, was associated with elevated spinal fluid pressure and abnormal spinal fluid cells morphologically similar to those seen in the Sezary syndrome. The symptoms were dramatically reversed by intrathecal methotrexate, brain irradiation, and steroids. Mycosis fungoides recurred in the skin, in the spinal fluid, and in both eyes. Despite continued systemic and intrathecal chemotherapy, the patient died from mycosis fungoides. This is the second patient reported with meningeal mycosis fungoides.

Antineoplastic Agents↗
PubMed1975

Immune response to primary immunization with brucella antigen in mycosis fungoides.

The immune response to primary immunization with brucella antigen was studied in 8 patients with mycosis fungoides and 11 controls. The development of as well cellular as humoral hypersensitivity to brucella antigen was followed by in vitro techniques. Both, patients with mycosis fungoides and controls were studied for previously acquired delayed hypersensitivity to tuberculin by skin test. The distribution of B and T cells was encountered among the patients. Previously acquired cellular immunity was found equal in the two groups, however, induction of cellular hypersensitivity to brucella antigen was found depressed in mycosis fungoides patients compared with the controls. Also the humoral response to brucella antigen could seem depressed, only one of seven patients with mycosis fungoides had a positive titer, while seven of eleven controls had positive titres following vaccination; but the difference between the two groups was not significant.

Adult↗
PubMed1976

Further evidence for the T-cell nature of the atypical mononuclear cells in mycosis fungoides.

It is well known that in some cases of mycosis fungoides the lymph nodes contain atypical mononuclear cells with a characteristic electron-microscopic morphology, first described in skin lesions of mycosis fungoides. Because it has been shown, that these cells have T-cell membrane characteristics the question can be raised, if these cells have other properties of T cells. One of these is a preferential localization in the T-cell dependent regions (paracortical areas) of the lymph node. In this paper we present a study of dermatopathic lymph nodes from four patients with mycosis fungoides (plaque stage). The lymph nodes of these patients contained atypical mononuclear cells in the paracortical areas only, and not in the follicles or medulla. In one of the patients we could demonstrate the migration of these cells through the epitheloid venules into the paracortical area. Our observations give further evidence of the T-cell nature of the atypical mononuclear cells in mycosis fungoides.

Adult↗
PubMed2003

[Mycosis fungoides in childhood and adolescence with clonal T-cell receptor gamma gene rearrangement. Two cases].

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma (CTCL) characterized by its typical progress in three stages: the patch-, the plaque- and the tumour-stage. The incidence of mycosis fungoides rises with age and the average age at presentation is about 50. Children and adolescents are rarely affected and there are only few reports in the literature. We report a 12- and a 15-year-old boy showing refractory skin lesions not typical for mycosis fungoides. The histo- and immunohistological investigations and the detection of clonal T-cell receptor gamma gene rearrangements confirmed the diagnosis of early onset mycosis fungoides in both cases.

Adolescent↗
PubMed2005

Treatment with IFN-gamma increases serum levels of Th1 chemokines and decreases those of Th2 chemokines in patients with mycosis fungoides.

BACKGROUND: Interferon-gamma (IFN-gamma) is used for the treatment of mycosis fungoides, which is a Th2 neoplasm with elevation of serum Th2 chemokines. Although therapeutic effectiveness of IFN-gamma is caused at least partly by augmented activity of cytotoxic T cells against the tumor cells, its modulation on chemokine production remains unknown. OBJECTIVE: Alterations in the serum levels of Th1 chemokines, IP-10 and MIG, and Th2 chemokines, TARC and MDC, were examined in mycosis fungoides patients treated with recombinant IFN-gamma. METHODS: Four patients with mycosis fungoides received intravenous injections of IFN-gamma for 14 or 28 days. On day 0, 7, 14, and 28, sera were obtained from the patients, and the concentrations of TARC, MDC, IP-10, and MIG were measured by ELISA, along with the percentages of peripheral blood Th1 and Th2 cells. RESULTS: Whereas the levels of TARC and MDC were decreased by IFN-gamma treatment, those of IP-10 and MIG were increased. In particular, the increment of MIG was remarkable. No substantial change of Th1 or Th2 cell number was observed. CONCLUSION: In IFN-gamma treatment as well as other therapies, TARC may serve as a marker for the disease activity of mycosis fungoides. The dramatic elevation of MIG by IFN-gamma suggests the strong dependency of MIG production on IFN-gamma and the participation of MIG in skin-infiltration of tumoricidal cytotoxic T cells.

Aged↗