Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
HUMAN T-CELL LEUKEMIA VIRUS (HTLV) INFECTION: A CLINICAL PERSPECTIVE
The Human Retroviruses. Gallo RC and Jay G, eds. San Diego, Academic Press, p. 163-71, 1991.. Unique Identifier : AIDSLINE ICDB/92678726 Takatsuki K; Second Dept. of Internal Medicine, Kumamoto Univ. Medical Sch.,; Kumamoto 860, Japan
Abstract:
Adult T-cell leukemia/lymphoma (ATL) was the first human cancer found to be caused by a retrovirus. The advances made in the worldwide study of AIDS owe much to the knowledge gained about the relation between ATL and HTLV-I. For example, methods of isolation almost identical to those used for HTLV-I were used for isolation of HIV. Also, HIV is tropic not only to helper T cells, but to the neural tissues. Studies on ATL are reviewed, including discovery of ATL; prototypic ATL; classification of ATL; diagnosis of ATL; other diseases accompanying HTLV-I infection; ATL cells; and prevention of HTLV-I infection and treatment of ATL. Variation in the clinical features of atypical ATL suggested the need to classify the spectrum of ATL into five types: acute, chronic, smoldering, crisis, and lymphoma. Practically, however, there are many patients with a transitional disease state who cannot be allocated definitely to any of these five types. Diagnosis of ATL usually is suggested by clinical and hematological characteristics and readily confirmed by showing positive anti-HTLV-I antibodies in the serum and typical phenotypic markers of leukemic cells. The clinical manifestations and the hematologic features of ATL are not caused by HTLV-I infection per se but by malignant proliferation of CD4+ peripheral T cells. HTLV-I infection is a direct cause of ATL and infection with this virus can be an indirect cause of, or contribute to, many other diseases, including chronic lung diseases, opportunistic infections, cancer of other organs, monoclonal gammopathy, and chronic renal failure. ATL cells have various chromosome aberrations, but no ATL-specific abnormality is known. It is possible that ATL cells release various active substances (cytokines) when activated and that these released substances modify the pathologic features of ATL patients. To prevent infection with HTLV-I, all samples of blood donated in Japan have been subjected to HTLV-I antibody testing since 1986. Past results of ATL chemotherapy show limited effectiveness. Recently, use of 2-deoxyformycin, a potent inhibitor of adenosine deaminase, produced a good response in 2/5 patients with ATL refractory to conventional chemotherapy. (36 Refs)
Keywords: Diagnosis, Differential Human HTLV-I/*PATHOGENICITY Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/ CLASSIFICATION/*DIAGNOSIS/MICROBIOLOGY/THERAPY Opportunistic Infections/DIAGNOSIS/MICROBIOLOGY/THERAPY T-Lymphocytes/MICROBIOLOGY MONOGRAPH REVIEW
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
