A study of adult T-cell leukemia/lymphoma incidence in central Brooklyn

Adult T-cell leukemia/lymphoma (ATL), a rare outcome of infection with huma n T-lymphotropic virus (HTLV-I), is endemic in central Brooklyn, which has a large Caribbean migrant population. Previous studies have suggested that HTLV-I prevalence in central Brooklyn may be similar to that recorded in th e Caribbean islands. We established a pilot 1-year surveillance program to identify cases of ATL in 7 of I 0 hospitals serving the residents of 18 zip codes of central Brooklyn with a combined population of 1,184,670, Of the 6,198 in-patient beds in the catchment area, approximately 83% were covered , Twelve incident cases of ATL were ascertained, all among persons of Afro- Caribbean descent, indicating an annual incidence in African-Americans in t his community of approximately 3.2/100,000 person-years. Unexplained hyperc alcemia was the most useful screening method, identifying 3 of 5 patients n ot referred for possible ATL by a local hematologist, The female:male ratio was 3:1. The age pattern was different from that reported in the Caribbean Basin and closer to the pattern seen in Japan. Our study supports evidence that HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive surveillance program for this disease coupled with i ntervention efforts to reduce HTLV-I transmission are warranted, Int. J. Ca ncer 80:662-666, 1999, Published 1999 Wiley-Liss, Inc.