[Clinical and laboratory evaluation of patients with adult T-cell lymphocytic leukemia dependent to HTLV1]

Human T cell lymphotropic virus 1 [HTLV1] infects an estimated 15-50 million individuals world wide, HTLV1 was the first virus demonstrated to be involved in the etiology of a human cancer, Adult T cell leukemia / lymphoma [ATLL]. Khorasan province in the northeast of Iran was introduced as a new endemic area with 2/3% sero prevalence for HTLV1 in 1985 [12, 13, 14]. This is the first comprehensive report of a case series study of the clinical and laboratory features of Iranian ATLL patients that compared whith other endemic area: Japan, Jamaica. In this study review total cases of ATLL between march 1995 and September 2001 was report to Ghaem and Emam reza Hospitals [mashhad university].These cases were included in the study if they had clinical and paraclinical signs for ATLL, positive HTL VAb, and establish T cell malignancy with history and at least 5 points according to the Levine registry criteria for definition of ATLL. then result of BMA, lymphnode and skin biopsies recorded. With shimoma criteria total patients divided to four group. There were 30 patients include 17 female and 13 male [M/F:1/1.3] with a mean age of 47 years [22-71 year] [fig 1]. The majority of cases were acute type [53.3%] followed by lymphoma [26.7%], chronic [10%] and smoldering [10%] type. [Chart 1]. The most common clinical features were skin lesion [63%], fever and weight loss [40%], gastrointestinal problems [37%], respiratory symptoms [26%], malaise [20%] and bone pain [10%]. [Fig 2] The most important clinical findings of patients were lymphadenopathy [67%] skin lesions [63%], splenomegaly [63%] hepatomegaly [23%]. The characteristic pattern of skin manifestation was maculopapular and nodular rash. [Fig 3]. The comparison of the distribution pattern of subtypes and mean survey time Iran with other endemic region, especially Japan, Jamaica was revealed close similarity to Jamaica figures. However skin lesions were more common in our report, and hypercalcemia and lyric bone lesions were less common in Iranian ATLL cases

Clinical manifestation of adult-T-cell lymphoma/leukemia associated with HTLV-1 in northeastern Iran

The association of adult T cell lymphoma-leukemia and progressive myelopathy with human T lymphotropic virus type I [HTLV-1] has been proved. Several areas in the world are considered to be endemic areas for this virus. Our survey of the general population, as well as a study of 13 cases of lymphoma/leukemia in Khorasan province, may confirm this region or others in Iran as part of the endemic area