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Sezary syndrome

Last edited: 4/15/2026

Overview

Sezary syndrome is a leukemic variant of cutaneous T-cell lymphoma characterized by the presence of Sezary cells in the peripheral blood, often accompanied by erythematous dermatitis and lymphadenopathy 1.

Diagnosis

  • Presence of Sezary cells in peripheral blood with characteristic features such as folded nuclei and cytoplasmic projections 1.
  • Atypical lymphocytes of T-phenotype identified through flow cytometry or immunophenotyping 1.
  • Skin biopsy showing typical cutaneous infiltration by malignant T-cells 1.
  • Bone marrow involvement may be present and should be evaluated 1.
  • Histopathological examination highlighting cerebriform nuclei and ultrastructural features 1.
  • Management

  • First-line treatment typically involves chemotherapy regimens such as CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) 1.
  • Immunotherapy with agents like interferon-alfa may be considered for selected patients 1.
  • Targeted therapies such as retinoids (e.g., bexarotene) are used in refractory cases 1.
  • Supportive care including topical corticosteroids and emollients for skin symptoms 1.
  • Special Populations

  • No specific data provided regarding pregnancy, pediatrics, or elderly populations in the given abstracts 1.
  • Comorbidities may influence treatment selection but specific recommendations are not detailed 1.
  • Key Recommendations

  • Confirm diagnosis through identification of Sezary cells in peripheral blood and characteristic ultrastructural features (Evidence: Weak) 1.
  • Initiate first-line treatment with CHOP chemotherapy regimen for systemic involvement (Evidence: Expert opinion) 1.
  • Consider immunotherapy with interferon-alfa for patients not responding to initial chemotherapy (Evidence: Weak) 1.
  • References

    1 Nair CN, Shinde S, Kumar A, Goyal R, Nadkarni KS, Advani SH. Sezary cells with hairy projections. Leukemia research 1999. link00124-6)

    Original source

    1. [1]
      Sezary cells with hairy projections.Nair CN, Shinde S, Kumar A, Goyal R, Nadkarni KS, Advani SH Leukemia research (1999)

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