Survival of patients with HTLV-I-associated lymph node lesions

Adult T-cell leukaemia/lymphoma (ATLL), is a malignant condition associated with human T-cell leukaemia virus type I (HTLV-I). Usually, although not u niformly, histopathological examination of the lymph nodes shows a pleomorp hic type. In addition, some patients with pre-overt ATLL show a Hodgkin's d isease-like morphology and lymph nodes in non-neoplastic carriers show feat ures of lymphadenitis. To characterize further the clinicopathological feat ures of HTLV-I-associated lymphadenopathy, the histopathological features o f the lymph nodes of 289 patients were classified into five types: lymphade nitis (n = 14), Hodgkin's-like (Hodgkin's) (n = 18), pleomorphic (medium an d large cells) (n = 219), pleomorphic small cell (n=11), and anaplastic lar ge cell (ALC) (n = 27), Survival data were analysed according to the histop athological features of the lymph nodes. The pleomorphic type, which showed typical features of ATLL, was associated with a highly aggressive course a nd an initially high mortality, followed by a rapid decrease in survival. T his pattern was also observed in patients with the ALC type. All cases with lymphadenitis were still alive at the end of the study, while survival pro gressively decreased in the Hodgkin's type. The small cell type shelved an initial. rapid decrease in survival followed by a plateau, These results sh ow that the survival trends of patients with pleomorphic and anaplastic lym ph node lesions are similar to those with ATL lymphoma, while patients with the lymphadenitis type of lesion were considered to have a non-neoplatic s tatus. There is at present no effective therapy for ATLL, but in the future , these classification and survival data might be useful for the selection of appropriate chemotherapeutic regimens for patients with ATLL, Copyright (C) 1999 John Wiley & Sons, Ltd.