1. ^*Department of Dermatology, Johns Hopkins Medical Institutes, Baltimore, Maryland, USA
2. ^†Department of Pathology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
3. ^‡Department of Oncology-Hematology; Kaiser-Permanente, Portland, Oregon, USA

Correspondence: Eric Vonderheid MD, 550 N. Broadway Building, Suite 1002, Baltimore, MD 21205, USA. Email: evonder1@jhmi.edu

Received 20 June 2004; Revised 15 August 2004; Accepted 20 September 2004.

Abstract

Antibodies directed against the chain of the T cell receptor (anti-V antibodies) are useful to identify the V repertoire of T cells in various diseases and to quantify numbers of V-bearing T cells. The goals of this study were to identify V+ cases of leukemic phase cutaneous T cell lymphoma (CTCL) and to compare the percentage of positive calls with other measures of blood tumor burden, i.e., lymphocyte subsets with a CD4+CD7- and CD4+CD26- phenotype and Sézary cell counts. Thirty-three of 49 (67%) cases of leukemic CTCL reacted with an anti-V antibody. When combined with reports from the literature, the frequency of V5 (probably V5.1) usage was relatively high when compared with V2 that is also frequently expressed by normal CD4+ T cells. The percentage of V+ cells correlated to the percentage of CD4+CD7- and CD4+CD26- cells for cases in which the neoplastic cells were deficient in expression of CD7 and CD26, respectively, but not the Sézary cell count. We hypothesize that the increased V5.1 usage in CTCL may be the result of depletion of V2 and other V-bearing T cells by staphylococcal superantigens prior to neoplastic transformation, resulting in a relative increase in the frequency of V5.1 usage in CTCL.