ESTIMATES OF NUCLEAR VOLUME IN PLAQUE AND TUMOR-STAGE MYCOSIS-FUNGOIDES - A NEW PROGNOSTIC INDICATOR

It is well documented that mycosis fungoides (MF), a cutaneous T-cell lymphoma, has a variable clinical course. Unbiased stereological estimates of three-dimensional volume-weighted mean nuclear size (nucl (v) over bar(v)) of mycosis cells were obtained in a retrospective study of 18 patients with a total of 34 biopsies of cutaneous plaque and tumor-stage MF. The value of nucl (v) over bar(v) in the first sampled biopsy, as well as the average and highest values, were determined in biopsies from each patient. The patients were divided into two groups, either above or below the group median. There was a strong positive correlation between shorter survival and an average value of nucl (v) over bar(v) > 104 mu m(3) or a highest value of nucl (v) over bar(v) > 126 mu m(3) (2p = 0.002 and 0.003, respectively). A nucl (v) over bar(v) > 91.6 mu m(3) in the first biopsy was also suggestive of a shorter survival (2p = 0.07). There was no clear pattern of nucl (v) over bar(v) evolution in the patients with multiple biopsies, but the impact of various therapeutic regimes cannot be assessed. Certain estimates of nucl (v) over bar(v) appear to be good prognostic indicators in plaque and tumor-stage MF, but further study of a larger series of patients is needed to corroborate these results and assess the impact of differing therapeutic regimes.