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The human T-cell leukemia/lymphoma virus associated with American adult
T-cell leukemia/lymphoma
DW Blayney, ES Jaffe, WA Blattner, J Cossman, M Robert-Guroff, DL Longo, PA Bunn and RC Gallo
The human T-cell leukemia/lymphoma virus (HTLV) is a novel type-C
retrovirus isolated from patients with T-lymphoproliferative malignancies.
Thirteen cases of HTLV-associated malignancy from US centers were studied
in detail. Ten of these cases share common clinical features and define a
typical virus-associated adult T-cell leukemia/lymphoma (ATL). All ten
patients presented with Ann Arbor stage IV lymphoma because of skin
involvement, bone marrow involvement, or lymphomatous leptomeningitis.
Lymphadenopathy occurred in 7 of 10 patients at presentation, and the
malignant cells were cytologically pleomorphic. Leukemia occurred in 60% of
the patients at presentation. Hypercalcemia was found initially in
two-thirds of the patients, with lytic bone lesions or positive bone scans
in 7 of 10. Complete remission occurred in 40%, but all have relapsed.
These cases closely resemble those virus-positive cases of adult T-cell
leukemia/lymphoma (ATL) reported from Japan and the Caribbean. Three
additional virus- positive patients had atypical presentations and
diagnoses (acute lymphocytic leukemia, Sezary's syndrome, leukemic
reticuloendotheliosis), usually with less aggressive clinical courses and
atypical demographic and laboratory features. Presence of HTLV serum
antibodies in cases of ATL (with hypercalcemia and circulating malignant
cells) appears to define a distinct clinicopathologic entity that may occur
in geographic clusters.
Volume 62,
Issue 2,
pp. 401-405,
08/01/1983
Copyright © 1983 by The American Society of Hematology
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