THE FIRST REPORT OF FAMILIAL ADULT T-CELL LEUKEMIA-LYMPHOMA IN THE UNITED-KINGDOM

We describe two siblings who developed adult T-cell leukaemia lymphoma (ATLL) within 4 years. Both were black of Afro-Caribbean extraction, but one had been born in the United Kingdom and had visited the Caribb ean only once. Both patients were HTLV-1 seropositive, as was their mo ther; their father and brother were negative. The older sibling had th e lymphoma form of ATLL, whilst the younger had chronic ATLL. The form er was unresponsive to chemotherapy and died of progressive disease; t he latter experienced transient responses to various treatments and is alive 5 years after presentation. Immunophenotyping showed a CD4(+), CD25(+) phenotype; Southern blot demonstrated a monoclonal integration of HTLV-I in the tissues involved. This report, of the first familial ATLL in the U.K., supports the suggestion of transmission of HTLV-I f rom mother to child and documents the development of ATLL in second-ge neration Caribbean immigrants.