Effect of Strongyloides stercoralis infection and eosinophilia on age at onset and prognosis of adult T-cell leukemia.
Onset of adult T-cell leukemia (ATL) usually follows a long period of viral latency. Strongyloides stercoralis infection has been considered a cofactor of leukemogenesis. Hypereosinophilia (HE) is also observed and could be associated with either the presence of parasites or the leukemic process. In non-Hodgkin's lymphoma, eosinophilia may or may not affect prognosis. To determine whether infection with S stercoralis and therefore eosinophilia has a significant effect on the development of ATL, we studied two variables in 38 patients: age at onset and median survival rate. Infected (Ss+) patients (n = 19) were younger (P = .0002) and survived longer (P = .0006) than uninfected (Ss-) patients (n = 19) (median age, 39 vs 70 years; median survival, 167 vs 30 days). Mean survival of patients with hypereosinophilia (HE+) was not significantly different from that of patients without hypereosinophilia (HE-) (P = .57). However, overall survival was longer for Ss + HE + patients than for Ss-HE-patients (P = .01; 180 vs 30 days) or Ss-HE + patients (P = .03; 180 vs 45 days). Among patients with mean survival more than 180 days, Ss + HE + patients survived longer (P = .028). Our data confirm that cofactors related to the environment, such as S stercoralis and hypereosinophilia associated with S stercoralis or human T-cell leukemia virus, type 1 (HTLV-1) might be important in HTLV-1-associated leukemogenesis and suggest that hypereosinophilia affects the prognosis of HTLV-1-associated leukemia.
Plumelle
Y
Y
Department of Hematobiology, University Hospital, Martinique, French West Indies.
Gonin
C
C
Edouard
A
A
Bucher
B J
BJ
Thomas
L
L
Brebion
A
A
Panelatti
G
G
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D004802:Eosinophilia / Q000401:mortality / Q000469:parasitology*; D005260:Female; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000401:mortality / Q000469:parasitology*; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate