This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Takatsuki, K. Articles by Itai, Y. Search for Related Content PubMed PubMed Citation Articles by Takatsuki, K. Articles by Itai, Y.

Clinical Diversity in Adult T-Cell Leukemia-Lymphoma¹

The Second Department of Internal Medicine, Kumamoto University Medical School, Honjo, Kumamoto 860 [K. T., K. Y., F. K., T. H., H. N., H. T., I. S.]; Okinawa Kyodo Hospital, Itoman, Okinawa 901-03 [K. N.]; and Minamata Kyoritsu Hospital, Minamata, Kumamoto 867 [Y. I.], Japan

Adult T-cell leukemia-lymphoma (ATL) is a unique T-cell cancer first described in Japan. We estimate that more than 200 patients a year have been detected in Kyushu. The surface phenotype of ATL cells characterized by monoclonal antibodies is T3⁺, T4⁺, T8^-, T11⁺, and Tac⁺. In all cases the serum is positive for anti-human T-cell leukemia (lymphotropic) virus (HTLV-I) antibodies and the ATL cells contain the proviral DNA of HTLV-I. Variations in the clinical features of atypical cases suggest a division of the spectrum of ATL into five types: acute (prototypic), chronic, smoldering, crisis, and lymphoma. Screening of the sera from healthy adults for presence of the anti-HTLV-I antibodies revealed that 3.6% of healthy individuals in Kumamoto Prefecture, which is located in the middle of Kyushu, were HTLV-I carriers. The percentage of positivity increased with age and was higher in females than in males. It varied from town to town, ranging from 0 to 17.6%. Family studies showed that the routes of natural infection of HTLV-I are from mother to child and also from husband to wife. The third route is blood transfusion. The borderline between the healthy carrier state and smoldering ATL remains unclear. In the endemic areas smoldering ATL is frequently diagnosed in patients with fungus infection of the skin, chronic lymphadenopathy, interstitial pneumonitis, chronic renal failure, and stronglyloidiasis. In addition our experiences with a concurrence of lymphoma-type ATL in three sisters and spontaneous remissions in a patient with chronic ATL are cited.

This article has been cited by other articles:

				T. Hidaka, S. Nakahata, K. Hatakeyama, M. Hamasaki, K. Yamashita, T. Kohno, Y. Arai, T. Taki, K. Nishida, A. Okayama, et al. Down-regulation of TCF8 is involved in the leukemogenesis of adult T-cell leukemia/lymphoma Blood, July 15, 2008; 112(2): 383 - 393. [Abstract] [Full Text] [PDF]