title: Pre-morbid human T-lymphotropic virus type I proviral load, rather than percentage of abnormal lymphocytes, is associated with an increased risk of aggressive adult T-cell leukemia/lymphoma.
abstract: Out of 153 newly referred human T-lymphotropic virus type I infected patients, 42 (27%) had 5% or more abnormal lymphocytes, consistent with the diagnosis of smoldering adult T-cell leukemia/lymphoma. The abnormal lymphocyte percentage was higher in patients with human T-lymphotropic virus type I associated inflammatory disease compared with asymptomatic carriers (P=0.006). Over 4.5 years median follow up, 4 patients, all with 10 or more human T-lymphotropic virus type I DNA copies/100 peripheral blood mononuclear cells at presentation, but only one with 5% or more abnormal lymphocytes at presentation, developed adult T-cell leukemia/lymphoma. Thus, high pre-morbid human T-lymphotropic virus type I proviral load, rather than fulfilment of the classification criteria for smoldering adult T-cell leukemia/lymphoma, was associated with an increased risk of developing aggressive adult T-cell leukemia/lymphoma.
authors.affiliation: National Centre for Human Retrovirology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hodson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Laydon
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Bain
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fields
authors.forename: Graham P
authors.initials: GP
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D015994:Incidence; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology / Q000821:virology*; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011533:Proviruses; D012306:Risk; D019562:Viral Load; D016662:Virus Integration; D055815:Young Adult