A stable aberrant immunophenotype characterizes nearly all cases of cutaneous T-cell lymphoma in blood and can be used to monitor response to therapy.

BACKGROUND: Abnormal variations in the expression level of some commonly expressed T-cell antigens are a feature of many T-cell malignancies. METHODS: We sought to assess the frequency of such abnormal antigen expression by flow cytometry in peripheral blood (PB) samples from patients with mycosis fungoides (MF) and Sézary syndrome (SS). We correlated presence of morphologically identifiable tumor cells on PB smear with the frequency of abnormalities in the level of expression of CD3, CD4, CD7, CD8 and CD26. We also examined the degree of stability of these abnormal findings in tumor cells over the course of disease. The flow cytometric findings in 100 PB samples from 44 patients, including 38 who had multiple sequential PB samples (2-8 samples each), were assessed. RESULTS: Abnormalities were seen in the expression level of one or more T-cell markers in 41 cases (93%) including CD3 in 34% of patients, CD4 in 54%, CD26 in 86% and CD 45 in 40% (10 cases tested). In all but 2 cases, the abnormal T-cell immunophenotype remained similar over the course of treatment and correlated with the relative numbers of tumor cells counted on PB smear. CONCLUSIONS: Using a standard T-cell panel, stable phenotypically aberrant T-cell populations representing the tumor are detected in the vast majority of involved PB samples in MF/SS and can be used to monitor response to therapy.

Treatment outcome in a graduate orthodontic clinic using the American Board of Orthodontics grading system.

Since 1999, the American Board of Orthodontics (ABO) has used the objective grading system (OGS) to grade clinical case reports; the ABO also encourages prospective candidates to use the system. Ninety-two cases that satisfied the specifications of 6 of the ABO's malocclusion categories were selected from the files of 500 consecutively completed patients in the graduate orthodontic clinic at the University of Illinois at Chicago; this was called the university group. A comparison group of 32 cases previously presented to the ABO was collected from 5 clinicians in the Chicago area who had passed the ABO examination and become board-certified between 1984 and 2000; this was called the ABO group. Fourteen of the 32 cases in the ABO group were presented to the ABO after implementation of the OGS; these were also analyzed separately. Overall, the ABO group lost fewer points (had lower OGS scores) than did the university group (P <.05); the ABO group comprised a highly selected sample. The university group had significantly (P <.05) better scores for root parallelism, whereas the ABO group had significantly better scores for occlusal contacts and overjet scores, possibly reflecting settling after appliance removal. Finishing in the anterior segment and the second molar region was better in the ABO group. Orthodontists are good at correcting spaces in the arch and are deficient in placing adequate torque in the buccal segments. No differences were found in OGS scores among the 6 malocclusion categories. This study suggests how university cases could be completed to a higher level of quality and how other samples could be evaluated to raise the level of orthodontic treatment outcome.