A study of adult T-cell leukemia/lymphoma incidence in central Brooklyn.
Adult T-cell leukemia/lymphoma (ATL), a rare outcome of infection with human T-lymphotropic virus (HTLV-I), is endemic in central Brooklyn, which has a large Caribbean migrant population. Previous studies have suggested that HTLV-I prevalence in central Brooklyn may be similar to that recorded in the Caribbean islands. We established a pilot 1-year surveillance program to identify cases of ATL in 7 of 10 hospitals serving the residents of 18 zip codes of central Brooklyn with a combined population of 1,184,670. Of the 6,198 in-patient beds in the catchment area, approximately 83% were covered. Twelve incident cases of ATL were ascertained, all among persons of Afro-Caribbean descent, indicating an annual incidence in African-Americans in this community of approximately 3.2/100,000 person-years. Unexplained hypercalcemia was the most useful screening method, identifying 3 of 5 patients not referred for possible ATL by a local hematologist. The female:male ratio was 3:1. The age pattern was different from that reported in the Caribbean Basin and closer to the pattern seen in Japan. Our study supports evidence that HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive surveillance program for this disease coupled with intervention efforts to reduce HTLV-I transmission are warranted.
National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. ZPL@CU.NIH.GOV
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Levine
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Dosik
E M
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Joseph
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Felton
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Bertoni
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Cervantes
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Moulana
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Miotti
L J
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Goberdhan
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Lee
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Daouad
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DaCosta
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Jaffe
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Cleghorn
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Kahn
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D000328:Adult; D000368:Aged; D003710:Demography; D005260:Female; D015481:HTLV-I Antibodies / Q000097:blood; D006801:Humans; D015994:Incidence; D007563:Jamaica / Q000208:ethnology; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010865:Pilot Projects; D011159:Population Surveillance; D012307:Risk Factors; D014300:Trinidad and Tobago / Q000208:ethnology
D015481:HTLV-I Antibodies