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The tumor microenvironment (TME) is central to their pathogenesis, with flow cytometry and histology being the gold standards for detecting malignant T cells within the TME. Alongside emerging molecular markers, particularly clonality analysis, these tools are indispensable for accurate diagnosis and treatment planning. Of note, adenosine signaling within the TME has been shown to suppress immune responses, affecting various cell types. The expression of CD39, CD73, and CD38, enzymes involved in adenosine production, can be elevated in MF and SS, contributing to immune suppression. Conversely, the expression of CD26, part of the adenosine deaminase\/CD26 complex, that degrades adenosine, is often lost by circulating tumoral cells. Flow cytometry has demonstrated increased levels of CD39 and CD73 on S\u00e9zary cells, correlating with disease progression and prognosis, while CD38 shows a variable expression, with its prognostic significance remaining under investigation. Understanding these markers\u2019 roles in the complexity of TME-mediated immune evasion mechanisms might enhance diagnostic precision and offer new therapeutic targets in CTCL.<\/jats:p>","DOI":"10.3390\/cells14040309","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:29:53Z","timestamp":1739935793000},"page":"309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The CD39\/CD73\/Adenosine and NAD\/CD38\/CD203a\/CD73 Axis in Cutaneous T-Cell Lymphomas"],"prefix":"10.3390","volume":"14","author":[{"given":"Liyun","family":"Lin","sequence":"first","affiliation":[{"name":"Laboratory of Immunogenetics, Department of Medical Sciences, University of Turin, 10126 Turin, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3504-2417","authenticated-orcid":false,"given":"Valentina","family":"Pala","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Bagot","sequence":"additional","affiliation":[{"name":"Dermatology Department, Saint-Louis Hospital, AP-HP, Universit\u00e9 Paris Cit\u00e9, Inserm U976, 75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7828-6211","authenticated-orcid":false,"given":"Ad\u00e8le","family":"de Masson","sequence":"additional","affiliation":[{"name":"Dermatology Department, Saint-Louis Hospital, AP-HP, Universit\u00e9 Paris Cit\u00e9, Inserm U976, 75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7053-7431","authenticated-orcid":false,"given":"Maxime","family":"Battistella","sequence":"additional","affiliation":[{"name":"Department of Pathology, H\u00f4pital Saint-Louis, AP-HP, Universit\u00e9 Paris Cit\u00e9, Inserm U976, 75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-8735","authenticated-orcid":false,"given":"Emmanuella","family":"Guenova","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Lausanne University Hospital (CHUV) and Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland"},{"name":"University Institute and Clinic for Immunodermatology, Medical Faculty, Johannes Kepler University, 4020 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0098-1406","authenticated-orcid":false,"given":"Simone","family":"Ribero","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Quaglino","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1182\/blood-2018-11-881268","article-title":"The 2018 update of the WHO-EORTC classification for primary cutaneous 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