LETTER TO THE EDITOR REGARDING “AN EVALUATION OF THE AST/ALT RATIO IN PATIENTS WITH MYCOSIS FUNGOIDES AND ITS ASSOCIATION WITH THE SEVERITY OF CUTANEOUS INVOLVEMENT”

Abstract

This letter provides a pathologist-oriented commentary on the study by Pala and Bayraktar examining the AST/ALT ratio in patients with mycosis fungoides. The discussion focuses on the pathobiological basis of the De Ritis ratio, emphasizing its association with cellular metabolism, disease burden, and potential extracutaneous involvement. While histopathological evaluation remains central to diagnosis, the AST/ALT ratio may serve as a readily accessible adjunctive biomarker in disease monitoring. Integrating biochemical parameters with pathological and clinical findings may enhance longitudinal assessment in mycosis fungoides.

Keywords

• mycosis fungoides
• alt
• ast

References

1. Pala E, Bayraktar M. An evaluation of the AST/ALT ratio in patients with mycosis fungoides and its association with the severity of cutaneous involvement. İst Tıp Fak Derg 2025;88(1):53-9. google scholar
2. Willemze R, Jaffe ES, Burg G, Cerroni L, Berti E, Swerdlow SH, et al. WHO-EORTC classification for cutaneous lymphomas. Blood 2005;105(10):3768-85. google scholar
3. Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M; ESMO Guidelines Committee. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018;29(Suppl 4):iv30-40. google scholar
4. Botros M, Sikaris KA. The De Ritis ratio: the test of time. Clin Biochem Rev 2013;34(3):117-30. google scholar
5. Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science 2009;324(5930):1029-33. google scholar