Evaluation of the role of TAX, HBZ, and HTLV-1 proviral load on the survival of ATLL patients

BACKGROUND: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive malignancy with very poor prognosis and short survival, caused by the human T-lymphotropic virus type-1 (HTLV-1). The HTLV-1 biomarkers trans-activator x (TAX) and HTLV-1 basic leucine zipper factor (HBZ) are main oncogenes and life-threatening elements. This study aimed to assess the role of the TAX and HBZ genes and HTLV-1 proviral load (PVL) in the survival of patients with ATLL. METHODS: Forty-three HTLV-1-infected individuals, including 18 asymptomatic carriers (AC) and 25 ATLL patients (ATLL), were evaluated between 2011 and 2015. The mRNA expression of TAX and HBZ and the HTLV-1 PVL were measured by quantitative PCR. RESULTS: Significant differences in the mean expression levels of TAX and HBZ were observed between the two study groups (ATLL and AC, P=0.014 and P=0.000, respectively). In addition, the ATLL group showed a significantly higher PVL than AC (P=0.000). There was a significant negative relationship between PVL and survival among all study groups (P=0.047). CONCLUSION: The HTLV-1 PVL and expression of TAX and HBZ were higher in the ATLL group than in the AC group. Moreover, a higher PVL was associated with shorter survival time among all ATLL subjects. Therefore, measurement of PVL, TAX, and HBZ may be beneficial for monitoring and predicting HTLV-1-infection outcomes, and PVL may be useful for prognosis assessment of ATLL patients. This research demonstrates the possible correlation between these virological markers and survival in ATLL patients.

[Is serum testosterone level higher in patients with breast cancer with unfavorable histopathologic factors?]

Breast cancer is more common in women with high serum testosterone level. Few studies showed that high level of serum testosterone is associated with poor prognosis. The association of testosterone level with histopathological findings has not been studied yet. In this study we investigated this association. Patients referred to a medical oncology clinic with no history of previous chemotherapy, hormone therapy, oophorectomy, or other cancers enrolled in the study. Morning serum testosterone was checked. Histopathologic findings were extracted from pathologic reports. Relationship between testosterone level and histopathologic types was analysed. 106 patients were studied whose mean age was 47 +/- 10 years. 63.2% of our patients were premenopausal. Histopathologic factors were unfavourable in 50%. The rate of vascular invasion was 56.4% and 73% were receptor positive. Mean level of serum testosterone was 0.56 +/- 0.52 ng/ml in patients with favourable histopathology and 0.70 +/- 0.77 ng/ml with unfavourable histopathology [p<0.4]. No testosterone level was above normal range. There was no relation between serum testosterone level and histopathologic findings; viz. serum testosterone level was not higher in breast cancers with unfavourable histopathologic factors. So we need to conduct more studies to figure out the reasons for the poor prognosis observed in patients with higher levels of serum testosterone