ADULT T-CELL LEUKEMIA-LYMPHOMA - A CLINICOPATHOLOGICAL STUDY OF 26 PATIENTS FROM MARTINIQUE

Twenty-six cases of adult T-cell leukemia/lymphoma (ATLL) were identif ied between 1983 and 1991 in Martinique (French West Indies). There we re 14 men and 12 women, all of mixed racial descent and born in Martin ique. Their ages ranged from 23 to 95 years. The main clinical and lab oratory features at initial presentation were peripheral lymphadenopat hy (22 cases), hepatomegaly (11 cases), splenomegaly (10 cases), cutan eous lesions (12 cases), hypercalcemia (16 cases), refractory infectio n by Strongyloides stercoralis (12 cases), and pre-existing autoimmune disorders (4 cases). All patients had absolute lymphocytosis with cir culating pleomorphic abnormal lymphocytes. The prognosis was poor, wit h most patients (20 cases) surviving for less than 6 months. Although the overall clinicopathologic features of ATLL in this series are simi lar to those described in previous reports, we observed three addition al points of interest: a high association with Strongyloides infection , an increased incidence of tropical spastic paresis/HTLV-1 associated myelopathy (TSP/HAM) among the relatives of the patients (5 cases), a nd the presence of prior collagen vascular diseases.