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Prepublished online as a Blood First Edition Paper on November 21, 2002; DOI 10.1182/blood-2002-07-2247.
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Blood, 15 March 2003, Vol. 101, No. 6, pp. 2132-2135
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Cytomegalovirus seropositivity is significantly associated with
mycosis fungoides and Sézary syndrome
Kelly L. Herne,
Rakhshandra Talpur,
Joan Breuer-McHam,
Richard Champlin, and
Madeleine Duvic
From the Department of Dermatology, and Department of
Bone Marrow Transplantation, The University of Texas MD Anderson Cancer
Center, Houston.
Although mycosis fungoides (MF) may arise through persistent
antigen stimulation, cytomegalovirus (CMV) is not a known risk factor.
To study the incidence of seropositivity to viral infections, we
compared MF and Sézary Syndrome (SS) patients to healthy bone marrow donors and other historical control groups. Baseline screening serologies at baseline were performed on 116 biopsy-proven MF/SS patients at MD Anderson Cancer Center from 1992 to 2001 and on healthy
bone marrow donors evaluated by the transplant service from 1988 to
2001. Antibodies to HTLV-I/II, HIV-1, EBV, and CMV were measured using
standard enzyme-linked immunosorbent (ELISA) and membrane enzyme
immunoassay (MEIA) assays. One hundred thirteen (97.4%) of all MF/SS
patients had positive CMV IgG serologies at initial presentation.
Early- and late-stage patients' seropositivity rates were
significantly higher than healthy bone marrow donor controls
( 2.05(df=1) = 71.79). By stage,
98.1% of early-stage MF patients (IA, IB, IIA; 52/53) and 96.8% of
late-stage MF and SS patients (IIB-IVB; 61/63) were seropositive
compared with healthy bone marrow donors whose seropositivity
rate was 57.3% (757/1322). Because the rate of CMV seropositivity
increases with age, a subset of cutaneous T-cell lymphoma (CTCL)
patients 55 years or younger were compared to age-matched healthy donor
controls; their seropositivity rate for CMV was also
significantly higher (2.05 05(df=1) =
20.4). EBV titers were positive by serology in 13 patients who
were examined prospectively. CMV seropositivity is highly associated
with MF and SS, even in the earliest stages of the disease, and is
significantly higher than that of healthy and immunocompromised controls.
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