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This retrospective cohort study discovered that specific T-cell receptor beta (TCRB) and gamma (TCRG) clonotypes correlate with aggressive clinical features and decreased overall survival in cutaneous T-cell lymphoma (CTCL), particularly mycosis fungoides (MF) and Sézary syndrome (SS). Notably, clonal Vb20 and Vg8 segments were linked to advanced disease stages, folliculotropism, large-cell transformation, and poorer prognosis. Additionally, higher clonal abundance of TCRG correlated positively with immune checkpoint markers PD-1 and ICOS, suggesting an immunomodulatory milieu in aggressive disease.
