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Blood, 1 February 2006, Vol. 107, No. 3, pp. 1241-1242. This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gupta, R. K. Articles by MacMahon, E. Search for Related Content PubMed PubMed Citation Articles by Gupta, R. K. Articles by MacMahon, E. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CORRESPONDENCE To the editor: Cytomegalovirus seroprevalence is not higher in patients with mycosis fungoides/Sezary syndrome The novel work by Herne et al1 reported very high seroprevalence of cytomegalovirus (CMV) (97.4%) in patients with mycosis fungoides (MF) when compared with matched bone marrow donors (57.3% seropositivity) in a teaching hospital (University of Texas, M. D. Anderson Cancer Center, Houston, TX) in the United States. MF and the closely related Sézary syndrome (SS) comprise the most common variant of primary cutaneous T-cell lymphomas (CTCLs) and a common form of extranodal non-Hodgkin lymphoma. MF and SS present with cutaneous involvement characterized by patches, plaques, and tumors, along with erythroderma in SS. Histologically, MF and SS manifest pronounced epidermotropism with clonal CD4+/CD45RO+ tumor cells. The etiology is unknown. Other viruses, such as HTLV-1, can produce clinical and histologic features that mimic MF/SS as part of adult T-cell leukemia and lymphoma (ATLL), but studies have not shown clear evidence for an association between HTLV-1 and MF/SS.2,3 Infection with CMV is by intimate contact and is usually subclinical. Seroprevalence increases with age, and rates of CMV seropositivity vary across adult populations, from around 50% to 60% in developed nations4-6 to 95% in developing nations.4,7 CMV is not known to be oncogenic. Given this intriguing association between MF and CMV, we sought to reproduce Herne et al's finding by undertaking a retrospective blinded case-control study to compare the CMV seroprevalence rate in MF/SS patients compared with other patients attending a regional center for CTCL. The study had a power of 88% to detect a difference in prevalence of 30% between the 2 groups (60% in controls and 90% in MF/SS patients). Non-MF/SS patients attending the clinic served as controls. We tested stored serum samples from these patients for CMV IgG antibodies using two commercially available systems: one automated (Abbott Laboratories, Abbott Park, IL), and the other, a manual CMV IgG enzyme-linked immunosorbent assay (ELISA; Trinity Biotech, Bray, Ireland). Statistical analysis was performed using Epi Info version 6.04 (Centers for Disease Control and Prevention, Atlanta, GA). Age, sex, and ethnic origin were not statistically different between the MF/SS and non-MF/SS groups (Table 1). There was excellent correlation between the 2 different serologic assays. We found that 32 (60.4%) of 53 confirmed MF/SS patients were seropositive for CMV IgG, compared with 16 (61.5%) of 26 controls (P = .92). Seropositivity rates in early-stage (IA, IB, IIA) versus late-stage (IIB-IVB) MF/SS were 19 (54.3%) of 35 and 13 (72.2%) of 18, respectively (P = .24). Non-MF/SS patients had a range of diagnoses, including psoriasis, lichen simplex chronicus, dermatitis, and other cutaneous B-cell lymphomas. Median automated serology values for cases and controls revealed no significant differences. View this table: [in this window] [in a new window]   Table 1.. Comparison of baseline characteristics and CMV IgG seropositivity between MF/SS and non-MF/SS patients   Our findings failed to support those of Herne et al1 and showed no difference in CMV IgG seropositivity rates between MF/SS patients and other patients who attended our dermatology clinic who were similar in terms of age, sex, and race. We note that the study by Herne et al used bone marrow donors with prospective routine baseline CMV serology as controls. However, the MF/SS group was retrospectively tested for CMV IgG and may have been tested with a different assay. In our study, all samples were tested in parallel and showed almost complete concordance between the 2 assays. These conflicting findings need to be resolved by further studies. Ravindra Kumar Gupta, John Ramble, C. Y. William Tong, Sean Whittaker, and Eithne MacMahon Correspondence: Eithne MacMahon, Department of Infection, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, United Kingdom; e-mail: eithne.macmahon{at}gstt.nhs.uk. References Herne KL, Taipur R, Breuer-McHam J, Champlin R, Duvic M. Cytomegalovirus seropositivity is significantly associated with mycosis fungoides and Sezary syndrome. Blood.2003; 101:2132 -2136.[Abstract/Free Full Text] Whittaker S, Luzatto L. HTLV-1 and mycosis fungoides.Science . 1993;258:1470 -1471. Li G, Vowels B, Benoit B, Rook A, Lessin S. Failure to detect human T-lymphotropic virus type 1 (HTLV-1) proviral DNA in cell lines and tissues from patients with cutaneous T-cell lymphoma. J Invest Dermatol. 1996;107:308 -313.[CrossRef][Medline] [Order article via Infotrieve] Krech U, Tobin J. A collaborative study of cytomegalovirus antibodies in mothers and young children in 19 countries. Bull World Health Organ. 1981;59:605 -610.[Medline] [Order article via Infotrieve] Rothenbacher D, Hoffmeister A, Bode G, Wanner P, Koenig W, Brenner H. Cytomegalovirus and coronary heart disease: results of a German case-control study. J Infect Dis.1999; 179:690 -692.[CrossRef][Medline] [Order article via Infotrieve] Gratacap-Cavallier B, Bosson JL, Morand P, et al. Cytomegalovirus seroprevalence in French pregnant women: parity and place of birth as major predictive factors. Eur J Epidemiol.1998; 14:147 -152.[CrossRef][Medline] [Order article via Infotrieve] Kothari A, Ramachandran VG, Gupta P, Singh B, Talwar V. Seroprevalence of cytomegalovirus among voluntary blood donors in Delhi, India. J Health Popul Nutr.2002; 20:348 -351.[Medline] [Order article via Infotrieve] CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Cytomegalovirus seropositivity is significantly associated with mycosis fungoides and Sézary syndrome Kelly L. Herne, Rakhshandra Talpur, Joan Breuer-McHam, Richard Champlin, and Madeleine Duvic Blood 2003 101: 2132-2135. [Abstract] [Full Text] [PDF] This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gupta, R. K. Articles by MacMahon, E. 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