Cutaneous T-cell lymphoma: neoplasm of T cells with helper activity

Neoplastic lymphocytes from 3 patients with aleukemic cutaneous T-cell lymphoma were studied to determine if their neoplastic T cells had helper activity.i.e., ability to promote immunoglobulin synthesis by normal human B cells.Homogeneous populations of neoplastic T cells were isolated from involved lymph nodes and in two of three instances were shown to be of monoclonal origin by karyotypic analysis.Mononuclear leukocytes from control peripheral blood were separated into T-and B-cellenriched fractions by E-rosette formation and subsequent Ficoll-Hypaque flotation.Pokeweed-mitogen-stimulated normal and malignant T cells were co-cultured with normal B cells.Cytocentrifuged cell prepa-rations were stained with fluoresceinconjugated goat antihuman immunoglobulin to quantitate immunoglobulin-producing B cells.Addition of control T-cell fractions to control B-cell fractions increased the number of labeled cells from 8 to 34.Neoplastic T cells increased the numbers of normal B cells containing cytoplasmic immunoglobulin to a mean of 1 25, demonstrating exceptional helper activity.These results support a relationship between the S#{233}zarysyndrome. previously demonstrated to be a leukemia of helper T cells, and aleukemic cutaneous T-cell lymphoma and suggest that malignant helper T cells have a distinct affinity for the skin.Portions of lymph nodes, all with complete effacement of normal architecture, were obtained from 3 patients with aleukemic cutaneous T-cell lymphoma.One patient, E.O. (Table 1), had histologically