Correspondence

Absence of Human T-Cell Lymphotropic Virus Type I in Cutaneous T-Cell Lymphoma

N Engl J Med 1997; 336:296-297January 23, 1997

Article

To the Editor:

The cutaneous T-cell lymphomas include mycosis fungoides, the Sézary syndrome, and other sporadic primary T-cell proliferations in the skin.1,2 The human T-cell lymphotropic virus type I (HTLV-I) is a retrovirus that causes adult T-cell leukemia–lymphoma, which can also involve the skin and be difficult to distinguish from a primary cutaneous T-cell lymphoma. Recently, several investigators have found the HTLV-I genome in DNA from primary cutaneous T-cell lymphomas and proposed a causal relation between that retrovirus and such lymphomas.3-5 However, their studies have not always differentiated the diagnosis of cutaneous T-cell lymphoma from that of smoldering adult T-cell leukemia–lymphoma.4 Patients with cutaneous T-cell lymphoma who were seropositive for HTLV-I were included,4 and non–T-cell lines established from patients with cutaneous T-cell lymphoma were used to detect HTLV-I.3,5 In an area of endemic adult T-cell leukemia–lymphoma such as Japan, the diagnosis of cutaneous T-cell lymphoma is critical, because the treatment and prognosis of adult T-cell leukemia–lymphoma differ considerably from those of cutaneous T-cell lymphoma.

We tested 128 specimens of fresh lesional skin, peripheral-blood mononuclear cells, and T-cell clones from 50 Japanese patients with cutaneous T-cell lymphoma who had indolent clinical courses and typical pathological findings — cutaneous T-cell lymphoma expressing markers of mature T cells and no serum anti–HTLV-I antibodies. A total of 21 specimens from five patients with smoldering adult T-cell leukemia–lymphoma and two HTLV-I–positive patients with cutaneous T-cell lymphoma were used as positive controls. Using a polymerase chain reaction with four sets of primers, we found that none of the 128 specimens were positive for HTLV-I, whereas the 21 specimens from the positive controls were all positive with all sets of primers (Table 1Table 1Results of Polymerase-Chain-Reaction (PCR) Assay for HTLV-I in Patients with Cutaneous T-Cell Lymphomas.).

We conclude that in Japanese patients cutaneous T-cell lymphoma does not contain the HTLV-I genome.

Arata Kikuchi, M.D.
Takeji Nishikawa, M.D.
Keio University School of Medicine, Tokyo 160, Japan

Kazunari Yamaguchi, M.D.
Kumamoto University School of Medicine, Kumamoto 860, Japan

5 References

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   Manca N, Piacentini E, Gelmi M, et al. Persistence of human T cell lymphotropic virus type 1 (HTLV-1) sequences in peripheral blood mononuclear cells from patients with mycosis fungoides. J Exp Med 1994;180:1973-1978[Erratum, J Exp Med 1995;181:441.]
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Citing Articles (3)

Citing Articles

1. 1

   Mustafa Erhan Altunöz, Ebubekir Şenateş, Atakan Yeşil, Turan Çalhan, Ayşe Oya Kurdaş Övünç. (2011) Patients with Inflammatory Bowel Disease Have a Lower Response Rate to HBV Vaccination Compared to Controls. Digestive Diseases and Sciences
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2. 2

   Christophe Nicot. (2005) Current views in HTLV-I-associated adult T-cell leukemia/lymphoma. American Journal of Hematology 78:3, 232-239
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3. 3

   Nishikawa, Takeji, , Yamaguchi, Kazunari, , Saruta, Takao, . (1999) Retraction: Absence of Human T-Cell Lymphotropic Virus Type I in Cutaneous T-Cell Lymphoma. New England Journal of Medicine 340:23, 1837-1837
   Full Text | Original Article