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Adult T Cell Leukemia/Lymphoma

Adult T cell leukemia/lymphoma (ATLL) is a neoplasm of CD4 + T cells, caused by human T cell lymphotrophic virus I (HTLV-I), manifested by skin infiltrates, hypercalcemia, visceral involvement, lytic bone lesions, and abnormal lymphocytes on the peripheral smears.

Causes of Adult T Cell Leukemia

  • Generally the risk of NHL increases with advancing age. HL in the elderly is associated with a poorer prognosis than that observed in younger patients.
  • Black hair dye, which for more than 20 years has been linked to higher rates of NHL.
  • Inherited immunodeficiency diseases (severe combined immunodeficiency, ataxia telangiectasia, among a host of others)
  • Viruses — Human T-lymphotropic virus type I (HTLV-1) and Epstein-Barr virus are two infectious agents that increase the chance of developing non-Hodgkin’s lymphoma.

Symptoms of Adult T Cell Leukemia

  • Lymph node swelling, often in the upper body area.
  • A lack of energy, general fatigue.
  • Weight loss
  • Fevers which can come and go. ;
  • Night sweats – unexplained sweating at night, often drenching
  • Itching
  • Enlargement of the spleen may cause abdominal pain or discomfort.

Diagnosis

Characteristic clinical findings, seropositivity to HTLV-I, confirmation of integration of HTLV-I proviral DNA in the cellular DNA of the ATLL cells.

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Treatment

Various regimens of cytotoxic chemotherapy; the rates of complete response are < 30%, and responses lack durability. The acute and lymphomatous forms resist conventional cytotoxic chemotherapy. Excellent results have been obtained with the combination of oral zidovudine and subcutaneous interferon-α. Obtain HTLV-I serology of family members, sexual partners. If seropositive, should not donate blood.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095573/
  2. http://www.archivesofpathology.org/doi/full/10.5858/arpa.2012-0379-RS?code=coap-site
  3. https://www.sciencedirect.com/topics/medicine-and-dentistry/adult-t-cell-leukemia-lymphoma
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