Detection and characterization of human T-cell lymphotropic virus type I
(HTLV-I) associated T-cell neoplasms in an HTLV-I nonendemic region by
polymerase chain reaction
A Chadburn, E Athan, R Wieczorek and DM Knowles
Department of Pathology, Columbia University College of Physicians and
Surgeons, New York, NY 10032.
Human T-cell lymphotropic virus type I (HTLV-I) associated adult T-cell
leukemia/lymphoma (ATLL) occurs endemically in southwestern Japan, the
Caribbean, and West Africa, but occurs sporadically in most of the rest of
the world. However, because ATLL and non-HTLV-I associated T-cell neoplasms
share overlapping clinicopathologic features, the prevalence of ATLL in
nonendemic regions is unknown. In this study, 75 T-cell neoplasms randomly
procured from the metropolitan New York City area were examined by
polymerase chain reaction (PCR) for the presence of integrated HTLV-I
proviral sequences. HTLV-I genomic sequences were detected by PCR in 6 of
the 75 cases (8%); this result was confirmed by Southern blot
hybridization. The clinicopathologic features of the HTLV- I positive and
HTLV-I negative T-cell neoplasms were then compared. Although the
clinicopathologic features of patients from these two groups overlapped,
some findings were more commonly associated with HTLV-I positive neoplasms.
Five of the six patients with HTLV-I positive neoplasms were from HTLV-I
endemic areas, five were black, five were women, and five were less than 45
years of age, while the majority of the patients with HTLV-I negative
T-cell malignancies were elderly white men. The incidence of hypercalcemia
and lytic bone lesions was significantly more common among patients with
HTLV-I positive T-cell neoplasms (P less than .001 and P = .004,
respectively). The immunophenotypes of the HTLV-I positive and negative
tumors were similar; however, all HTLV-I positive neoplasms were CD7
negative (P less than .001). In summary, our findings: (1) demonstrate the
special clinicopathologic and immunophenotypic features of HTLV-I positive
T-cell neoplasms, (2) suggest that most of the rare cases of
HTLV-I-associated T-cell neoplasms occurring in HTLV-I nonendemic areas are
actually endemic cases; and (3) that PCR is a sensitive, clinically useful
technique for identifying HTLV-I associated T-cell neoplasms.
Volume 77,
Issue 11,
pp. 2419-2430,
06/01/1991
Copyright © 1991 by The American Society of Hematology
