In Vitro Evaluation of Immune Responses in Cutaneous T-Cell Lymphoma (CTCL)

This is an in vitro evaluation of cutaneous T-cell lymphoma using patients blood and tissue to evaluate immune responses related to identified tumor populations and dendritic/ CD 8 cells with the following objectives:

• Objective I: Evaluate the feasibility of the preparation of dendritic cells (DCs), CD8 and Sezary cells (all CD4 positive) in vitro, obtained from the buffy coats or a skin biopsy from an area with tumor involvement of subjects with cutaneous t-cell lymphoma (CTCL) and Sezary syndrome (leukemic stage of CTCL) undergoing an approved FDA therapy, extracorporeal photopheresis (ECP).
• Objective II: Evaluate antigen loading of the DCs.
• Objective III: Test the functional capacities of the DCs derived from CTCL subjects to overcome immune tolerance to the tumor cells ex-vivo, by using modified Elispot assay in conjunction with Granzyme B Elispot assay as a measurement of cytotoxicity.

Inclusion criteria

• Males or females <18 years of age
• Histologically confirmed stage IV cutaneous T-cell lymphoma, with at least 5% of the peripheral blood lymphocytes showing atypical morphology consistent with Sezary cells
• Ambulatory and be in stable medical condition
• Biopsy positive mycosis fungoides/CTCL or clonal type of CTCL as determined by PCR for TCR and Southern blot for TCR

Exclusion criteria

• Received any chemotherapy or radiotherapy within 4 weeks prior to enrollment
• Significant psychiatric illness which would prevent adequate informed consent in the opinion of the principal investigator
• Systemic steroid therapy other than maintenance for adrenal suppression
• Known coagulopathy for non SS subjects.