Human T-lymphotropic virus type 1 proviral loads in patients with adult T-cell leukemia-lymphoma: comparison between cutaneous type and other subtypes.
Human T-lymphotropic virus type 1 proviral loads in patients with adult T-cell leukemia-lymphoma: comparison between cutaneous type and other subtypes.
复制标题
成人 T 细胞白血病-淋巴瘤患者中人类 T 淋巴细胞病毒 1 型前病毒载量：皮肤型与其他亚型的比较。
DOI：
10.1111/1346-8138.13004
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发表时间：
2015
期刊：
影响因子：
3.1
通讯作者：
Kanekura T.
中科院分区：
文献类型：
--
作者：
Yonekura K;Utsunomiya A;Takatsuka Y;Takeuchi S;Tokunaga M;Kubota A;Takeda K;Kanzaki T;Uchida Y;Kawai K;Kanekura T.
成人T细胞白血病-淋巴瘤(ATL)具有不同的临床病理特征，分为急性、淋巴瘤、慢性和阴燃四种临床亚型，不同临床亚型的治疗策略不同。皮肤型ATL被建议用来描述阴郁型ATL的一种特殊亚型，在这种亚型中皮肤主要受到影响。然而，皮肤型ATL的诊断标准和预后因素仍有待确定。因此，我们进行了一项回顾性研究，以获得准确的亚型分类方法，并明确定义皮肤型ATL。入选ATL患者87例，其中急性患者31例，淋巴瘤患者6例，慢性患者24例，阴燃患者26例。根据不同类型ATL的临床特点，检测外周血中人类T淋巴细胞病毒I型(HTLV-1)前病毒载量和血清可溶性白介素2受体(sIL-2R)水平。HTLV-1前病毒载量在急性型和慢性型显著升高，血清sIL-2R水平在急性型和淋巴瘤型升高。HTLV-1前病毒载量在皮肤中显著低于其他阴燃类型的无皮肤损害的ATL。皮肤型ATL的临床表现也不同于其他亚型。这些结果表明，联合检测HTLV-1前病毒载量和血清sIL-2R水平有助于鉴别不同类型的ATL，并强烈提示皮肤型ATL是一个独特的临床实体。
Adult T‐cell leukemia–lymphoma (ATL), characterized by various clinicopathological features, is divided into four clinical subtypes, namely, acute, lymphoma, chronic and smoldering types, and the treatment strategy differs according to the clinical subtype. The designation cutaneous type ATL has been proposed to describe a peculiar subgroup of smoldering type ATL in which the skin is predominantly affected. However, diagnostic criteria and prognostic factors for cutaneous type ATL remain to be determined. Therefore, we performed a retrospective study to obtain a precise method for subtype classification and to clearly define cutaneous type ATL. A total of 87 ATL patients (acute,n= 31; lymphoma,n= 6; chronic,n= 24; smoldering,n= 26) were enrolled. The human T‐lymphotropic virus type I (HTLV‐1) proviral load in peripheral blood and the serum soluble interleukin‐2 receptor (sIL‐2R) level were evaluated with respect to the clinical features of the different types of ATL. The HTLV‐1 proviral load was significantly increased in the acute and chronic type and the serum sIL‐2R level was increased in the acute and lymphoma type. The HTLV‐1 proviral load was significantly lower in cutaneous than other smoldering types of ATL without skin lesions. The clinical findings of cutaneous type ATL were also different from other subtypes. These results indicate that, in combination, determination of the HTLV‐1 proviral load and the serum sIL‐2R level is useful for distinguishing among the different types of ATL, and strongly suggest that cutaneous type ATL is a distinct clinical entity.