Method for Diagnosing and Staging Cutaneous T-Cell Lymphoma Using Gene Expression in Blood Cells
Cutaneous T-cell lymphoma (CTCL) is a form of non-Hodgkin's lymphoma that affects the skin and involves malignant T-lymphocytes. There are about 20,000 patients with CTCL in North America and about 14,000 patients in Europe. The disease usually occurs in middle-aged adults and develops over an extended period of time. CTCL is difficult to diagnose, especially in its early stages, since the symptoms closely resemble those of more common skin ailments. If correctly diagnosed and treated early, CTCL patients can expect to survive for many years. However, the survival rate decreases as the disease progresses to more advanced stages. As a result, a major need exists for methods that can provide reliable early-stage diagnosis of CTCL.
To address this need, scientists at Wistar have identified gene expression profiles using complementary DNA (cDNA) microarray technology that can help in the diagnosis of patients with CTCL. By combining quantitative PCR (qPCR) and linear discriminant analysis, the scientists have adapted the cDNA microarray method and developed a reliable and practical diagnostic for CTCL using as few as 5 genes.
Additionally, expression patterns of a small number of genes (less than 10) can be predictive of patients that will undergo rapid advancement of the disease. Using this technology, gene expression patterns in samples from patients with Sezary Syndrome, an aggressive form of CTCL, were distinguishable from those in patients with more indolent stages of the disease. These changes may contribute significantly to the development and progression of CTCL and provide markers for the use of more aggressive forms of therapy than may otherwise be recommended.
These technologies may be useful in creating early-stage diagnostics for CTCL, to enhance the effectiveness of treatments for patients and in aiding the development of new therapeutics for CTCL.
Kari, L. et al., Jour. Exp. Med., 197, 1477-88, 2003