title: Risk factors for adult T-cell leukemia among carriers of human T-lymphotropic virus type I.
abstract: The presence of circulating "flower cells" and a low prevalence of antibody to Tax regulatory protein of human T-lymphotropic virus type I (HTLV-I) are characteristics of adult T-cell leukemia (ATL). To examine the predictability of levels of HTLV-I antibodies and of flower cell-like abnormal lymphocytes (Ably) for the risk of ATL among asymptomatic HTLV-I carriers, we prospectively evaluated the levels of viral markers of five HTLV-I carriers who developed ATL and 38 age-, sex-, and screen-matched HTLV-I-positive controls in the Miyazaki Cohort Study. After accounting for matching factors, Ably level was slightly, but not significantly, higher among cases than among controls (P =.13). Anti-HTLV-I (odds ratio [OR] = 1.6 per twofold dilution; 95% confidence interval [CI] 0.94, 3.8) was associated with ATL diagnosis, but antibody to Tax regulatory protein (anti-Tax) was not (OR = 0.78; 95% CI 0.26, 1.7). Anti-Tax level was low for all ATL cases for up to 10 years preceding their diagnosis, independent of the level of anti-HTLV-I titer. HTLV-I carriers with a higher anti-HTLV-I titer and a lower anti-Tax reactivity may be at greatest risk of ATL.
authors.affiliation: Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA, USA. mh280i@nih.gov
authors.forename: M
authors.initials: M
authors.lastname: Hisada
authors.forename: A
authors.initials: A
authors.lastname: Okayama
authors.forename: S
authors.initials: S
authors.lastname: Shioiri
authors.forename: D L
authors.initials: DL
authors.lastname: Spiegelman
authors.forename: S O
authors.initials: SO
authors.lastname: Stuver
authors.forename: N E
authors.initials: NE
authors.lastname: Mueller
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D002353:Carrier State / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D016356:Gene Products, tax / Q000276:immunology; D015481:HTLV-I Antibodies / Q000097:blood / Q000276:immunology; D015490:HTLV-I Infections / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D015368:Human T-lymphotropic virus 1 / Q000276:immunology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013601:T-Lymphocytes / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D016356:Gene Products, tax; D015481:HTLV-I Antibodies