Sezary Syndrome 101 21 August 2004
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Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse NY

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Re: Sezary Syndrome 101

Sezary Syndrome is a clinical manifestation in certain patients with T cell leukaemia.

HTLV does indeed cause some cases of ATL. However, not all - anyone with a grasp of oncogenesis would understand why this would be the case. And not all cases of ATL become Mycosis Fungoides which overlaps with Sezary syndrome.

The HUT-78 cell line was derived from a patient with Sezary Syndrome. But this is not the same cell line that HTLV was derived from.

By assuming that (a) all ATL is synonymous with HTLV infection and (b) all ATL is synonymous with Sezary syndrome the Perth Group are highlighting a lack of clinical knowledge and understanding. It is through oversimplifications like that they have come to their erroneous conclusions about HIV and AIDS.

HUT-78 is not infected with HTLV, although it is a good subtrate for HTLV culture. The cell line used for Gallo's HTLV isolation was HUT102. Clearly not HUT78. It takes approximately 5-10 minutes to discover this fact from scratch using online databases of cell lines and literature.

For their education the relevant papers are freely available in PubMed Central.

Gallo isolates HTLV-1 and distinguishes its RT from than of cellular polymerases:

http://www.pubmedcentral.nih.gov/picrender.fcgi?ar tid=350514&action=stream&blobtype=pdf

HUT78 doesn't contain HTLV-1:

http://www.pubmedcentral.nih.gov/pic render.fcgi?artid=171228&action=stream&blobtype=pdf

There should be no "according to the HTLV experts", because if the Perth Group recall their medical training they would not only know that Sezary was a manifestation of ATL, and that HTLV caused ATL but additionally that the relationship wasn't 100%. This is "according to undergraduate medical students":

Mycosis Fungoides: Cutaneous T-cell lymphoma of unknown origin. Associated with HTLV in some patients. Complications: Sezary's Syndrome. (From "First Aid for USMLE Step 2" 4th Edition p109-111).

Competing interests: None declared