Successful management of the Sézary syndrome. Mobilization and removal of extravascular neoplastic T cells by leukapheresis.

NEOPLASTIC thymus-derived (T) lymphocytes often have a characteristic tissue distribution.1 Unlike the abnormal bone-marrow-derived (B) lymphocytes of classic chronic lymphocytic leukemia and lymphosarcoma-cell leukemia,2 3 4 5 6 the leukemic T cells in the Sezary syndrome1 , 7 , 8 and in an unclassified leukemia9 preferentially infiltrate the skin and remarkably spare the bone marrow. Similarly, the neoplastic T cells in mycosis fungoides,1 a disorder probably related to the Sezary syndrome,10 11 12 characteristically localize in the skin, forming plaques and tumors. Many of the clinical sequelae of these T-cell neoplasms result from accumulation of malignant cells in extravascular sites; therefore, a prime therapeutic goal in their management is removal . . .

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