To the Editor.—
We have recently noted large, apparently random, day-to-day fluctuations in the relative number of circulatory Sézary cells in the peripheral blood of patients with Sézary syndrome. The Figure depicts such a situation in a 70-year-old man with a three-year history of documented Sézary syndrome. The flucPrednisone, 30mg 25mg 20mg 12 10 2 28 30 31 3 4 6 7 8 9 10 11 12 13 14 Jan Feb Daily count of Sézary cells in peripheral blood. tuating Sézarycytosis was observed during a period when the patient was hospitalized for exacerbation of his erythroderma. For several months prior to this hospitalization, the patient had been receiving a single daily oral dose of 30 mg of prednisone and a dose of 2 mg of chlorambucil (Leukeran) twice daily. The dose of prednisone was decreased twice during the period in which serial Sézary cell counts were done. The patient