VircapSeq Virus Detection in Sézary Syndrome

Cutaneous T-cell lymphoma (CTCL) is a rare lymphoproliferative disorder characterized by
malignant CD4+ T-cells that infiltrate the skin. While most cases are confined to skin, CTCL
is also capable of affecting the blood, lymph nodes, and visceral organs. Sézary Syndrome
(SS) is a leukemic variant of the disease with a poor prognosis and can arise with or
without cutaneous involvement. The pathogenesis of CTCL is poorly understood, but chronic
antigen stimulation possibly due to a bacterial or viral infection or colonization of the
skin may lead to malignant transformation of the skin resident T cells. Colonization of the
skin of CTCL patients with Staphylococcus aureus is common and can lead to the clonal
expansion of malignant T cells in the skin. However, its role as an etiological agent is
unlikely, considering commonality of S.aureus and rarity of the skin T-cell lymphomas.
Mounting evidence suggests that oncogenic viral pathogen may play a role, but all efforts to
implicate certain viruses, such as retroviruses or herpesviruses have yielded inconsistent
results. This study will use the most sensitive method to date, a novel viral detection
technique capable of detecting every known vertebrate virus in tissue samples, called
"Virome Capture Sequencing Platform for Vertebrate Viruses (VirCapSeq-VERT)." This allows it
to detect previously undiscovered viruses that diverge from known sequences by as much as
40%.

Inclusion Criteria:

- Patients with Sézary syndrome diagnosed according to the WHO-EORTC classification.

Exclusion Criteria:

- Pregnant patients.

- Patients with known anemia with documented <7.5 mg/dL.

- Patients who are unable to give informed consent.