F. Cordoliani et al., FAMILIAL HTLV-1-ASSOCIATED ADULT T-CELL LEUKEMIA LYMPHOMA/, Annales de dermatologie et de venereologie, 125(10), 1998, pp. 708-710
Background. Adult T-cell leukemia-lymphoma (ATL) can occur in siblings
infected with HTLV-1. Case reports. Two Caribbean siblings developed
ATL a few years apart. One case has been reported previously. Both ind
ividuals had peripheral lymph node T-cell lymphoma and a few atypical
lymphocytes on blood smear. Lymphocytosis, bone marrow biopsy, abdomin
al computed tomographic scanning, and chest radiography were normal. C
lonal rearrangement of T-cell receptor was present in skin lesions for
both patients and in the blood for one. HTLV-1 serology was positive.
Clonal integration of HTLV-1 provirus was demonstrated in skin lesion
s in one patient and in blood lymphocytes in the other. Chemotherapy,
then interferon alpha, were unsuccessfull in the first patient. Topica
l metchloretamine was partially effective for the second patient. Disc
ussion. ATL in siblings is explained by mother-to-child transmission o
f HTLV-1 infection during breastfeeding.