Epidemiology and immunovirology of human T-cell leukemia/lymphoma virus type I-associated adult T-cell leukemia and chronic myelopathies as seen in France.
Seventeen patients with adult T-cell leukemia (ATL) and 21 with tropical spastic paraparesis/human T-cell leukemia/lymphoma virus type I (HTLV-I)-associated myelopathy (TSP/HAM) were observed during a 3-yr survey (1986-1988) in some hospitals in Paris, France. Most of them were black, originating from high-HTLV-I-endemic areas (West Indies or Africa), but two cases of TSP/HAM occurred in French Caucasians. In one case, the patient acquired the virus from a transfusion during a cardiac transplantation. Most of the ATL cases were diagnosed as acute leukemia or lymphoma, with a proliferation of CD2+, CD3+, CD4+, CD8-, DR+, and CD25+ lymphoid cells. Only three cases were diagnosed as a smoldering ATL. All of the TSP/HAM cases exhibited a spastic paraparesis with a chronic and slow evolution and high HTLV-I antibody titers in serum and cerebrospinal fluid, with a high HTLV-I antibody index and specific HTLV-I immunoglobulin = oligoclonal bands. In TSP/HAM, a high percentage of DR-expressing cells (15 to 40%) was found, with a slightly elevated CD4/CD8 ratio. This was associated with the presence of 1 to 10% abnormally shaped nuclei in lymphoid cells and a polyclonal integration of HTLV-I proviruses in these peripheral blood mononuclear cells. On the contrary, a clonal integration was always found in the ATL malignant cells (leukemic, lymph node, and cutaneous infiltrate). Long-term interleukin 2-dependent T-cell lines (CD2+, CD3+, CD4+, and WT31+) with activated T-cell markers (CD25+ and DR+) producing HTLV-I were established from ATL and TSP/HAM peripheral blood mononuclear cells.
CNRS Laboratory of Epidemiology and Immunovirology of Tumors, Faculté de Médicine Alexis Carrel, Lyon, France.
A
A
Gessain
O
O
Gout
F
F
Saal
M T
MT
Daniel
B
B
Rio
G
G
Flandrin
F
F
Sigaux
O
O
Lyon-Caen
J
J
Periès
G
G
de-Thé
D015703:Antigens, CD / Q000032:analysis; D005260:Female; D005602:France / Q000453:epidemiology; D015686:Gene Products, env / Q000032:analysis; D015481:HTLV-I Antibodies / Q000032:analysis; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology* / Q000276:immunology
D015703:Antigens, CD; D015686:Gene Products, env; D015481:HTLV-I Antibodies