Flower cells in patients with infective dermatitis associated with HTLV-1.
BACKGROUND
Infective dermatitis associated with HTLV-1 (IDH) is a severe childhood form of eczema that may progress to adult T-cell leukemia/lymphoma (ATL).


OBJECTIVE
In this study, the presence of clinical and laboratory parameters suggestive of ATL was evaluated in a cohort of 30 patients with IDH.


METHODS
Over a period of 33 months, the patients were submitted to three-monthly clinical evaluations, routine laboratory exams, full blood count and blood smears, and to six-monthly blood sampling for HTLV-1 proviral load determination. HTLV-1 proviral load was quantified using real-time TaqMan PCR assay.


RESULTS
Abnormal cells (Ably) were found in the peripheral blood smears of nine patients (30%), flower cells being detected in five of these cases (16.6%). The presence of Ably and flower cells was not associated with a higher proviral load in those patients.


CONCLUSIONS
This is the first report on the presence of flower cells in HTLV-1-infected children and adolescents. Furthermore, these cells have not previously been reported in IDH patients. The cases with flower cells probably represent precursory ATL cases, these patients being at a greater risk of developing ATL.
de Oliveira
Maria de Fátima Paim
Mde F
Department of Dermatology, Professor Edgar Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil.
Vieira
Maria das Graças
Md
Primo
Janeusa
J
Siqueira
Isadora C
IC
Carvalho
Edgar M
EM
Farré
Lourdes
L
Fatal
Priscila Lima
PL
Bittencourt
Achiléa L
AL
D000293:Adolescent; D001769:Blood / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003584:Cytological Techniques; D003872:Dermatitis / Q000821:virology*; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification; D017193:Skin Diseases, Viral / Q000175:diagnosis* / Q000821:virology