Human T-cell leukemia virus type I (HTLV-1) proviral load and disease progression in asymptomatic HTLV-1 carriers: a nationwide prospective study in Japan
Human T-cell leukemia virus type I (HTLV-1) proviral load and disease progression in asymptomatic HTLV-1 carriers: a nationwide prospective study in Japan
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无症状 HTLV-1 携带者的人类 T 细胞白血病病毒 I 型（HTLV-1）前病毒载量和疾病进展：日本的一项全国性前瞻性研究
DOI：
10.1182/blood-2009-12-257410
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发表时间：
2010-08-26
期刊：
影响因子：
20.3
通讯作者：
Yamaguchi, Kazunari
中科院分区：
文献类型：
--
作者：
Iwanaga, Masako;Watanabe, Toshiki;Yamaguchi, Kazunari
无症状人类T细胞白血病病毒I型（HTLV-1）携带者发生成人T细胞白血病（ATL）的危险因素尚不清楚。最近，HTLV-1前病毒载量已被评估为ATL的重要预测因子，但已进行了一些小型前瞻性研究。我们前瞻性地评估了1218例无症状HTLV-1携带者（426例男性和792例女性），他们在2002年至2008年期间入组。入组时男性的前病毒负荷显著高于女性（中位数，2.10 vs 1.39拷贝/100个外周血单核细胞[PBMC]; P <0.001），40 ~ 49岁和50 ~ 59岁组较40岁及以下组（P分别为0.02和0.007），有ATL家族史的患者比无ATL家族史的患者（中位数为2.32 vs 1.33拷贝/100 PBMC; P = 0.005）。在随访期间，14名参与者进展为明显的ATL。其基线前病毒载量较高（范围，4.17-28.58拷贝/100个PBMC）。在基线前病毒载量低于约4个拷贝的受试者中，没有人发生ATL。多变量考克斯分析表明，不仅更高的前病毒载量，高龄，ATL家族史，以及在治疗其他疾病期间首次进行HTLV-1检测的机会是ATL进展的独立危险因素。（血。2010; 116（8）：1211-1219）
Definitive risk factors for the development of adult T-cell leukemia (ATL) among asymptomatic human T-cell leukemia virus type I (HTLV-1) carriers remain unclear. Recently, HTLV-1 proviral loads have been evaluated as important predictors of ATL, but a few small prospective studies have been conducted. We prospectively evaluated 1218 asymptomatic HTLV-1 carriers (426 males and 792 females) who were enrolled during 2002 to 2008. The proviral load at enrollment was significantly higher in males than females (median, 2.10 vs 1.39 copies/100 peripheral blood mononuclear cells [PBMCs]; P < .001), in those 40 to 49 and 50 to 59 years of age than that of those 40 years of age and younger (P = .02 and .007, respectively), and in those with a family history of ATL than those without the history (median, 2.32 vs 1.33 copies/100 PBMCs; P = .005). During follow-up, 14 participants progressed to overt ATL. Their baseline proviral load was high (range, 4.17-28.58 copies/100 PBMCs). None developed ATL among those with a baseline proviral load lower than approximately 4 copies. Multivariate Cox analyses indicated that not only a higher proviral load, advanced age, family history of ATL, and first opportunity for HTLV-1 testing during treatment for other diseases were independent risk factors for progression of ATL. (Blood. 2010; 116(8): 1211-1219)