Autopsy and Case Reports
Autopsy and Case Reports
Clinical Case Report

HTLV-1 infection in acute t- lymphocytic leukemia/lymphoma

Mohammad Barouqa; Morayma Reyes Gil; Radhika Sekhri; Mojisola Popoola; Juan Ding; Yanhua Wang

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Adult T- lymphocyte leukemia/ lymphoma (ATLL), described by Uchiyama et al. in 1977, is a distinct neoplasia of peripheral T-lymphocytes caused by human T-cell lymphotropic virus type 1 (HTLV-1). The authors describe the case of a 75-year-old female patient who presented with fever, chills, and altered mental status. The peripheral blood morphology showed large atypical lymphocytes with multilobed nuclei and flow cytometry consistent with ATLL. The authors discuss the pathophysiology, differential diagnosis, and subtypes of ATLL in addition to the diagnostic approach using flow cytometry when bone marrow biopsy is not available and modalities of treatment.


Human T-lymphotropic virus 1, Leukemia, Lymphoid, Leukemia-Lymphoma, Adult T-Cell


1 Uchiyama T, Yodoi J, Sagawa K, Takatsuki K, Uchino H. Adult T-cell leukemia: clinical and hematologic features of 16 cases. Blood. 1977;50(3):481-92. PMid:301762.

2 Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci USA. 1980;77(12):7415-9. PMid:6261256.

3 Osame M, Usuku K, Izumo S, et al. HTLV-I associated myelopathy, a new clinical entity. Lancet. 1986;327(8488):1031-2. PMid:2871307.

4 LaGrenade L, Hanchard B, Fletcher V, Cranston B, Blattner W. Infective dermatitis of Jamaican children: a marker for HTLV-I infection. Lancet. 1990;336(8727):1345-7. PMid:1978165.

5 Manns A, Hisada M, LaGrenade L. Human T-lymphotropic virus type I infection. Lancet. 1999;353(9168):1951-8. PMid:10371587.

6 Gessain A, Cassar O. Epidemiological aspects and world distribution of HTLV-1 infection. Front Microbiol. 2012;3:388. PMid:23162541.

7 Hino S. Establishment of the milk-borne transmission as a key factor for the peculiar endemicity of human T-lymphotropic virus type 1 (HTLV-1): the ATL Prevention Program Nagasaki. Proc Jpn Acad Ser B Phys Biol Sc. 2011;87(4):152-66. PMid:21558754.

8 Roucoux DF, Wang B, Smith D, et al. A prospective study of sexual transmission of human T lymphotropic virus (HTLV)-I and HTLV-II. J Infect Dis. 2005;191(9):1490-7. PMid:15809908.

9 Inaba S, Sato H, Okochi K, et al. Prevention of transmission of human T-lymphotropic virus type 1 (HTLV-1) through transfusion, by donor screening with antibody to the virus. One-year experience. Transfusion. 1989;29(1):7-11. PMid:2643213.

10 Murphy EL, Watanabe K, Nass CC, Ownby H, Williams A, Nemo G. Evidence among blood donors for a 30-year-old epidemic of human T lymphotropic virus type II infection in the United States. J Infect Dis. 1999;180(6):1777-83. PMid:10558931.

11 Iwanaga M, Watanabe T, Yamaguchi K. Adult T-cell leukemia: a review of epidemiological evidence. Front Microbiol. 2012;3:322. PMid:22973265.

12 Oliveira PD, Farre L, Bittencourt AL. Adult T-cell leukemia/lymphoma. Rev Assoc Med Bras. 2016;62(7):691-700.

13 Saito H. Paraneoplastic syndrome hematologic abnormalities. Gan To Kagaku Ryoho. 1991;18(3):337-42. PMid:2003736.

14 Tsukasaki K, Hermine O, Bazarbachi A, et al. Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: a proposal from an international consensus meeting. J Clin Oncol. 2009;27(3):453-9. PMid:19064971.

15 Bittencourt AL, Barbosa HS, Vieira MD, Farre L. Adult T-cell leukemia/lymphoma (ATL) presenting in the skin: clinical, histological and immunohistochemical features of 52 cases. Acta Oncol. 2009;48(4):598-604. PMid:19165640.

16 Dupuis J, Boye K, Martin N, et al. Expression of CXCL13 by neoplastic cells in angioimmunoblastic T-cell lymphoma (AITL): a new diagnostic marker providing evidence that AITL derives from follicular helper T cells. Am J Surg Pathol. 2006;30(4):490-4. PMid:16625095.

17 Lemonnier F, Cairns RA, Inoue S, et al. The IDH2 R172K mutation associated with angioimmunoblastic T-cell lymphoma produces 2HG in T cells and impacts lymphoid development. Proc Natl Acad Sci USA. 2016;113(52):15084-9. PMid:27956631.

18 Tsukasaki K, Imaizumi Y, Tawara M, et al. Diversity of leukaemic cell morphology in ATL correlates with prognostic factors, aberrant immunophenotype and defective HTLV-1 genotype. Br J Haematol. 1999;105(2):369-75. PMid:10233406.

19 Tobinai K. Current management of adult T-cell leukemia/lymphoma. Oncology. 2009;23(14):1250-6. PMid:20120837.

20 Taylor GP, Matsuoka M. Natural history of adult T-cell leukemia/lymphoma and approaches to therapy. Oncogene. 2005;24(39):6047-57. PMid:16155611.

21 Gonçalves DU, Proietti FA, Ribas JG, et al. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev. 2010;23(3):577-89. PMid:20610824.

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