Increased cancer antigen 27.29 (CA27.29) level in patients with mycosis fungoides Putao Cen,MD, a Madeleine Duvic, MD, b,c Philip R.Cohen,MD, b,c,d and Razelle Kurzrock, MD a Houston,Texas Background: Mycosis fungoides, also called cutaneous T-cell lymphoma, comprise a group of extranodal, indolent non-Hodgkin’s lymphomas of T-cell origin with primary involvement of the skin. There are few data available on tumor markers in these patients. Cancer antigen 27.29 (CA27.29), which is expressed on most carcinoma cells, is a soluble form of the glycoprotein MUC1. Measuring CA27.29 has been approved by the US Food and Drug Administration for monitoring disease activity in patients with breast cancer. Objective:We sought to assess whether CA27.29 levels were increased in patients with cutaneous T-cell lymphoma and whether there was a correlation of this marker with tumor response. Methods: We evaluated the CA27.29 blood levels from 6 patients with advanced mycosis fungoides (who had no evidence of breast cancer) and reviewed their charts for information about history and physical examinations, laboratory data, pathology findings, and radiologic examinations. Results: We demonstrated that 3 of 6 patients with advanced mycosis fungoides had markedly elevated CA27.29 blood levels. In the two patients who had serial blood levels drawn, CA27.29 increased or decreased during treatment as the disease progressed or responded, respectively. Limitations: This study reflects pilot data on a limited number of patients. Conclusions: Our observations suggest thatCA27.29 merits further investigation as a tumor marker in patients who have cutaneous T-cell lymphoma. ( J Am Acad Dermatol 2008;58:382-6.) M ycosis fungoides (MF), also called cutane- ous T-cell lymphoma (CTCL), comprises a group of uncommon extranodal, indolent non-Hodgkin’slymphomasof T-cell origin with primary involvement of the skin. 1 Patients are staged according to skin, lymph node, blood, and visceral involvement, and staging correlates with progno- sis. 2,3 Increased levels of serum beta-2 microglobulin and/or lactate dehydrogenase in CTCL have been found to correlate with high tumor burden and can predicttransformation to large-cell lymphoma. 3,4 However, overall, there is still a dearth of predictive markersfor CTCL, and the role of other tumor markers in this disease has not been explored. Cancer antigen 27.29 (CA27.29) is a soluble form of MUC1, a mucinlike glycoprotein that is abun- dantly expressedon most carcinomacells. 5-8 Abbreviations used: CA27.29:cancer antigen 27.29 CHOP: cyclophosphamide, doxorubicin, vincristine, and prednisone CMED: cyclophosphamide, methotrexate, etoposide, and dexamethasone CTCL: cutaneous T-cell lymphoma FDA: Food and Drug Administration MF: mycosis fungoides sMUC1: soluble MUC1 From the Department of Investigational Cancer Therapeutics (Phase I Program), Division ofCancer Medicine, a and Department of Dermatology, b University of Texas MD Anderson Cancer Center; Department of Dermatology, University of Texas-Houston Med- ical School c ; and University of Houston Health Center. d Supported in part by grant RR024148 from the National Center for Research Resources (NCRR), a component of the National Insti- tutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view ofNCRR orNIH.Infor- mation on NCRR is available at http://www.ncrr.nih.gov/. Infor- mation on Re-engineering the Clinical Research Enterprise can be obtained from http:/nihroadmap.nih.gov/clinicalresearch/ overview-translational.asp. Conflicts of interest: None declared. Accepted for publication December 16, 2007. Reprint requests: Razelle Kurzrock, MD,Department of Investiga- tional Cancer Therapeutics (Phase I Program), Division of Cancer Medicine, MD Anderson Cancer Center, Box 455, PO Box 301402, Houston, TX 77030. E-mail: rkurzroc@mdanderson.org. 0190-9622/$34.00 ª 2008 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2007.12.014 382