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Adult T-cell leukemia/lymphoma in Jamaica and its relationship to human T-cell leukemia/lymphoma virus type I-associated lymphoproliferative disease
Int Symp Princess Takamatsu Cancer Res Fund;15: 77-90, 1984.
em Inglês | MedCarib | ID: med-10543
Biblioteca responsável: JM3.1
Localização: JM3.1;
ABSTRACT
We had shown previously that the prevalence of human T-cell leukemia/lymphoma virus type I (HTLV-I) antibody positivity is high in Jamaican non-Hodgkin's lymphoma (NHL) patients and that virus-positive patients have the clinical features and poor prognosis of adult T-cell leukemia/lymphoma (ATL). 62 percent of 45 NHL patients diagnosed consecutively between 2/1/82 and 1/31/84 and studied prospectively were HTLV-I-antibody positive. Skin involvement (38 percent), hypercalecemia (44 percent), and leukemia (40 percent) were unusually prevalent and there was a strong association (p < 0.05) with HTLV-I-antibody positivity. 52 percent of the patients had bone marrow infiltration, and 74 percent of these patients were HTLV-I-antibody positive (p=.06). Lymphadenopathy (96 percent), hepatomegaly (60 percent), and splenomegaly (25 percent) were detected with about the same frequency as in other series of NHL patients with advanced disease, and 61-88 percent of these patients were HTLV-I-antibody positive. Patients were classified into those with "typical ATL" (NHL associated with 2 of the 4 features) i) hypercalecemia; ii) histologically proven skin infiltration; iii) leukemia; and iv) bone marrow infiltration, providing that the morphology of infiltrating of leukemic cells was characteristic of ATL; those "consistent with ATL" (NHL associated with 1 of these 4 features); and "non-ATL" (NHL without any of these 4 additional features). Thirty-two (71 percent) of the NHL patients were ATL patients, i.e. had features typical of or consistent with ATL, and 78 percent of these were HTLV-I-antibody positive. HTLV-I provirus was detected in tumour cells of all HTLV-I-antibody positive patients tested. Three (23 percent) of the non-ATL patients were HTLV-I-antibody positive. There was no correlation between histopathological features and the clinical classification of HTLV-I-antibody positivity. Median survival of ATL and non-ATL patients was 16 and 53 weeks. Although the disease was unusually fulminant, 34 percent of the ATL patients had a subacute or chronic course. Skin involvement and leukemia were prominent in these patients. Hypercalecemia was the chief prognostic determinant. Median < 0.05). Hypercalecemia caused 10 deaths, infections 12, and death was due to tumour progression in 4 patients. Infections were usually due to pyogenic organisms and only 2 patients had systemic opportunistic infections. Six (27 percent) of 22 chronic lymphocytic leukemia (CLL) patients were HTLV-I-antibody positive. (AU)
Assuntos
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Coleções: Bases de dados internacionais Base de dados: MedCarib Assunto principal: Leucemia / Deltaretrovirus / Linfoma / Anticorpos Antivirais Tipo de estudo: Estudo de etiologia / Estudo prognóstico / Fatores de risco Limite: Adolescente / Adulto / Idoso / Criança / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: Int Symp Princess Takamatsu Cancer Res Fund Ano de publicação: 1984
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Coleções: Bases de dados internacionais Base de dados: MedCarib Assunto principal: Leucemia / Deltaretrovirus / Linfoma / Anticorpos Antivirais Tipo de estudo: Estudo de etiologia / Estudo prognóstico / Fatores de risco Limite: Adolescente / Adulto / Idoso / Criança / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: Int Symp Princess Takamatsu Cancer Res Fund Ano de publicação: 1984
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