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Prepublished online as a Blood First Edition Paper on November 21, 2002; DOI 10.1182/blood-2002-07-2247.
Submitted July 25, 2002
Accepted October 20, 2002
Cytomegalovirus seropositivity is significantly associated with Mycosis Fungoides and Sezary Syndrome
Kelly L Herne, Rakhshandra Talpur, Joan Breuer-McHam, Richard Champlin, and Madeleine Duvic*
Department of Dermatology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
Department of Bone Marrow Tranplantation, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
* Corresponding author; email: mduvic{at}mdanderson.org.
Mycosis Fungoides (MF) is hypothesized to arise through persistent antigen stimulation, but Cytomegalovirus (CMV) has not previously been identified as a risk factor. To study the incidence of seropositivity to viral infections, we compared MF and Sezary Syndrome patients to healthy bone marrow donors and other historical control groups. One hundred sixteen biopsy proven MF/SS patients had screening serologies done with baseline evaluation at MD Anderson Cancer Center from 1992 to 2001. Antibodies to HTLV-I/II, HIV-1, EBV, and CMV were measured using standard ELISA and MEIA assays. Control subjects were healthy bone marrow donors evaluated by the transplant service at MD Anderson from 1988 to 2001, as well as historical patients and controls reported in the literature. 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 in contrast to healthy bone marrow donors whose seropositivity rate was 57.3% (757/1,322). Since rate of CMV seropositivity increases with age, a subset of CTCL patients  55 years were compared to age-matched healthy donor controls and also had a higher seropositivity rate for CMV (2.05(df=1) = 20.4). EBV titers were also positive by serology in thirteen patients who were examined prospectively. CMV seropositivity is highly associated with Mycosis Fungoides and Sezary Syndrome, even in the earliest stages of the disease, and is significantly higher than in healthy and immunocompromised control groups.
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