Luay M. Luay Mustafa Kasem Hamade Immunological and morphological criteria for the mycosis fungoides diagnosis and treatment

The aim of this dissertation is to analyze the theoretical data pool regarding mycosis fungoides (MF) and find new effective methods and ways that will be applied in differential diagnosis and treatment of early-stage MF while taking in account depressed functions of the cellular local and systemic immune responses. According to the immunohistochemical study results obtained in biopsy samples that were collected from patients with early to advanced-stage MF, there are different number of affected skin cells detected in the lesions sites that are capable of activation markers CD25 and HLA-DR expression. The above mentioned characteristics mainly relate to the affected cells in stage IА. The research data demonstrate that cutaneous infiltrates in patients with stage IIB IA disease have a predominance of lymphocytes that display the phenotype of memory T cells (CD4+CD45RO+ Т lymphocytes). The immunohistochemical study results obtained in biopsy samples that were collected from patients with MF in early IА stage show local clustering of the activated cells (CD1a, HLA-DR molecule expression), Langerhans cells presence as well as cutaneous inflammatory infiltrates near the epidermis While comparing the results of immunohaematology examinations of the blood samples collected from patients with stages IА and IIB MF there have been identified some peculiarities which are considered characteristic to MF in stage IIB. It can be said for sure that the number of CD3+CD45+ cells as well as the population of T cells CD45+CD3+CD4+CD8-T have increased. Also the quantity of cells that express markers CD45+CD4+CD45RA+CD45RO- (naive T helper cells) and CD45+CD4+CD45RA-CD45RO+ (activated memory T cells) among which may be malignant clones have also grown. It has been determined that patients with MF in stage IIB have increased serum Th2 profile cytokine level (IL-4, IL-5, IL-10) and decreased Th1 profile cytokine level (IL-2 and IFN-?). The data obtained can be used in clinical practice to determine the MF transition from stage IА to IIB. Prospidium chloride has demonstrated in clinical trials to provide clinical benefit for patients with stage IA and IIB disease. The current data regarding changes of key lymphocyte subpopulations composition in peripheral blood that have been gathered after the treatment clearly demonstrated considerable improvement of patients' with early-stage disease health.