In this issue of the ARCHIVES, Juarez et al1 studied the prognostic value of nodal T-cell receptor gene rearrangement analysis in cutaneous T-cell lymphoma (CTCL). They found that the predictive outcome value of T-cell clonality by any method was inferior to that of a simple clinical skin assessment (T stage). They also found that clinical detection of lymphadenopathy (N1 stage) was pragmatically more relevant than finding a T-cell clone by polymerase chain reaction (PCR). Furthermore, they concluded that the old Southern blot clonality test, which has been broadly replaced by more practical and sensitive PCR-based analysis, was more effective than PCR in predicting a poor outcome. All 15 study patients with positive clonality by Southern blot died in less than 10 years.
Guitart J. Beyond Clonal Detection: Defining the T-Cell Clone. Arch Dermatol. 2005;141(9):1159–1160. doi:10.1001/archderm.141.9.1159
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