Cytomegalovirus infection is not necessarily a poor prognostic factor in adult T-cell leukemia/lymphoma

The relationship between cytomegalovirus (CMV) antigenemia and the clinical course was examined in 57 patients with adult T-cell leukemia/lymphoma (AT LL). All patients included had the acute/lymphoma type of ATL according to the criteria of the Japan Lymphoma Study Group (LSG). CMV antigenemia was a ssessed on admission and at the time when the patients had fever higher tha n 37.5 degrees C, which did not re spend to antibiotics for longer than 3 d ays. The incidence of CMV antigenemia was 44%. Approximately 90% of patient s with CMV antigenemia died of infections with viruses, bacteria, and/or fu ngi, while approximately 40% of patients without CMV antigenemia died of de terioration of ATLL (P<0.0001). in this study, the patients with CMV antige nemia tended to survive longer than those negative for it (321.4 days vs. 2 66.2 days), although there was no statistical significance (P=0.09). Kaplan -Meier analysis revealed that CMV antigenemia was not a poor prognostic fac tor. When the disease status of ATLL was evaluated by thymidine kinase (TK) and soluble interleukin 2 receptor (slL-2R), both had lower titers during CMV antigenemia (TK: P=0.01, slL-2R: P=0.03, respectively). Therefore, CMV infections in ATLL patients seemed to have bimodal meanings; CMV infection at the end of clinical course were life-threatening, but infection during t he first half of clinical course seemed to suppress ATLL activity and to co ntribute to the longer survival of the patients. (C) 2000 Wiley-Liss, Inc.