HTLV-I-positive and HTLV-I-negative peripheral T-cell lymphomas in Taiwan Chinese.
The clinico-pathologic features of 107 adult Chinese patients with peripheral T-cell lymphoma (excluding primary cutaneous lymphoma) are described and a comparison between HTLVI+ and HTLV-I- patients is made. There were 27 HTLV-I+ and 80 HTLV-I- patients. The virus-positive and -negative groups both had a male predominance and an identical median age of 48. Most patients in both groups presented with stage-IV disease, B symptoms, lymphadenopathy and hepatosplenomegaly. The HTLV-I+ group had a significantly higher incidence of skin and pulmonary lesions, bone marrow and peripheral blood involvement, hypercalcemia, and elevated LDH level compared to the HTLV-I- group. Sinonasal lesions (10), mediastinal mass (5), and GI tract involvement (6) were only seen in the HTLV-I- group. Leukocytosis with the presence of circulating pleomorphic lymphoid cells was characteristic of HTLV-I+ cases, while cytopenia was more frequently present in HTLV-I- cases. All of the 24 HTLV-I+ patients tested were CD4+CD8-; of the 67 HTLV-I- patients tested, 46 were CD4+CD8-, 9 were CD4-CD8 , 5 were CD4-CD8- and 7 were CD4+CD8+. Phenotypic studies revealed significant differences in the expression of CD7 and CD25 between virus-positive and -negative groups. Both groups responded poorly to therapy. The median survival of HTLVI+ and HTLV-I- patients was 4 months and 13.5 months, respectively. Apart from the presence of more than 3 extranodal lesions, none of the other clinical features or histologic subtypes had prognostic significance in the entire group or either of the subgroups. This series of peripheral T-cell lymphomas in Taiwan indicate that HTLV-I+ and HTLV-I- patients had many features in common, but presented several distinct differences.
Shih
L Y
LY
Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Kuo
T T
TT
Dunn
P
P
Liaw
S J
SJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000208:ethnology; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D016411:Lymphoma, T-Cell, Peripheral / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology