{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:47:40Z","timestamp":1790675260209,"version":"4.1.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Cutaneous adverse events of both topical and systemic drugs in patients with mycosis fungoides (MF) present a diagnostic challenge as it is often difficult to distinguish drug associated rash from disease progression in the skin. Mogamulizumab and mechlorethamine gel are approved treatments for MF, both of which can cause treatment related cutaneous adverse events. It can often be challenging to distinguish mogamulizumab associated rash (MAR) and mechlorethamine gel associated hypersensitivity dermatitis from MF progression both clinically and histologically. High-throughput sequencing (HTS) of the T-cell receptor (TCR), also known as immunosequencing, can be used to assess T-cell clonality to support a diagnosis of MF. After identification of the malignant TCR clone at baseline, immunosequencing can track the established malignant TCR sequence and its frequency over time with high sensitivity. As a result, immunosequencing clone tracking can aid in distinguishing disease progression from treatment side effects. Here, we present a case series to demonstrate how monitoring of the malignant T-cell frequency by immunosequencing can aid in diagnosis of mogamulizumab and mechlorethamine gel cutaneous adverse events.<\/jats:p>","DOI":"10.3389\/fmed.2023.1243459","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T12:44:37Z","timestamp":1702644277000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Utility of T-cell immunosequencing in distinguishing mycosis fungoides progression from treatment related cutaneous adverse events"],"prefix":"10.3389","volume":"10","author":[{"given":"Safiyyah","family":"Bhatti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Joffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Banner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahithi","family":"Talasila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Mandel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Porcu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Nikbakht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"adv00544","DOI":"10.2340\/00015555-3911","article-title":"Management of Mycosis Fungoides with topical Chlormethine\/Mechlorethamine gel: a Columbia University cutaneous lymphoma center experience","volume":"101","author":"Garcia-Saleem","year":"2021","journal-title":"Acta Derm Venereol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1001\/jamadermatol.2021.0877","article-title":"Clinical characterization of Mogamulizumab-associated rash during treatment of mycosis Fungoides or S\u00e9zary syndrome","volume":"157","author":"Hirotsu","year":"2021","journal-title":"JAMA Dermatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1016\/S1470-2045(18)30379-6","article-title":"Mogamulizumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial","volume":"19","author":"Kim","year":"2018","journal-title":"Lancet Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.2147\/CMAR.S138661","article-title":"Management of mycosis fungoides-type cutaneous T-cell lymphoma (MF-CTCL): focus on chlormethine gel","volume":"11","author":"Denis","year":"2019","journal-title":"Cancer Manag Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1111\/cup.14243","article-title":"Application of the current diagnostic algorithm for early mycosis fungoides to a single center cohort: identification of challenges and suggestions for modification","volume":"49","author":"Krishnasamy","year":"2022","journal-title":"J Cutan Pathol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1136\/jclinpath-2017-204761","article-title":"T cell clonality assessment: past, present and future","volume":"71","author":"Mahe","year":"2018","journal-title":"J Clin Pathol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1038\/sj.leu.2403202","article-title":"Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 concerted action BMH4-CT98-3936","volume":"17","author":"van Dongen","year":"2003","journal-title":"Leukemia"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.3389\/fonc.2019.01558","article-title":"An update on molecular biology of cutaneous T cell lymphoma","volume":"9","author":"Walia","year":"2019","journal-title":"Front Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"eaar5894","DOI":"10.1126\/scitranslmed.aar5894","article-title":"High-throughput sequencing of the T cell receptor beta gene identifies aggressive early-stage mycosis fungoides","volume":"10","author":"de Masson","year":"2018","journal-title":"Sci Transl Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"308ra158","DOI":"10.1126\/scitranslmed.aaa9122","article-title":"TCR sequencing facilitates diagnosis and identifies mature T cells as the cell of origin in CTCL","volume":"7","author":"Kirsch","year":"2015","journal-title":"Sci Transl Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"214ra171","DOI":"10.1126\/scitranslmed.3007420","article-title":"Minimal residual disease monitoring with high-throughput sequencing of T cell receptors in cutaneous T cell lymphoma","volume":"5","author":"Weng","year":"2013","journal-title":"Sci Transl Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s13555-021-00624-7","article-title":"Dermatologic events associated with the anti-CCR4 antibody Mogamulizumab: characterization and management","volume":"12","author":"Musiek","year":"2022","journal-title":"Dermatol Ther (Heidelb)"},{"key":"ref13","doi-asserted-by":"crossref","DOI":"10.1001\/jamadermatol.2023.0826","article-title":"Emergence of Malignant T-Cell Intraclonal CDR3 Variants in Mycosis Fungoides","author":"Gleason","year":"2023","journal-title":"JAMA Dermatol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1243459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T15:10:08Z","timestamp":1702912208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1243459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":13,"alternative-id":["10.3389\/fmed.2023.1243459"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1243459","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]},"article-number":"1243459"}}