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Alvarez C, Gotuzzo E, Vandamme AM, Verdonck K. Family Aggregation of Human T-Lymphotropic Virus 1-Associated Diseases: A Systematic Review. Front Microbiol 2016; 7:1674. [PMID: 27840624 PMCID: PMC5083714 DOI: 10.3389/fmicb.2016.01674] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/06/2016] [Indexed: 01/09/2023] Open
Abstract
Human T-lymphotropic virus 1 (HTLV-1) is a retrovirus that produces a persistent infection. Two transmission routes (from mother to child and via sexual intercourse) favor familial clustering of HTLV-1. It is yet unknown why most HTLV-1 carriers remain asymptomatic while about 10% of them develop complications. HTLV-1 associated diseases were originally described as sporadic entities, but familial presentations have been reported. To explore what is known about family aggregation of HTLV-1-associated diseases we undertook a systematic review. We aimed at answering whether, when, and where family aggregation of HTLV-1-associated diseases was reported, which relatives were affected and which hypotheses were proposed to explain aggregation. We searched MEDLINE, abstract books of HTLV conferences and reference lists of selected papers. Search terms used referred to HTLV-1 infection, and HTLV-1-associated diseases, and family studies. HTLV-1-associated diseases considered are adult T-cell leukemia/lymphoma (ATLL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV-1-associated uveitis, and infective dermatitis. Seventy-four records reported HTLV-1-associated diseases in more than one member of the same family and were included. Most reports came from HTLV-1-endemic countries, mainly Japan (n = 30) and Brazil (n = 10). These reports described a total of 270 families in which more than one relative had HTLV-1-associated diseases. In most families, different family members suffered from the same disease (n = 223). The diseases most frequently reported were ATLL (115 families) and HAM/TSP (102 families). Most families (n = 144) included two to four affected individuals. The proportion of ATLL patients with family history of ATLL ranged from 2 to 26%. The proportion of HAM/TSP patients with family history of HAM/TSP ranged from 1 to 48%. The predominant cluster types for ATLL were clusters of siblings and parent-child pairs and for HAM/TSP, an affected parent with one or more affected children. The evidence in the literature, although weak, does suggest that HTLV-1-associated diseases sometimes cluster in families. Whether familial transmission of HTLV-1 is the only determining factor, or whether other factors are also involved, needs further research.
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Affiliation(s)
- Carolina Alvarez
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano HerediaLima, Peru; Department of Microbiology and Immunology, Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven-University of LeuvenLeuven, Belgium
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano HerediaLima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Cayetano HerediaLima, Peru
| | - Anne-Mieke Vandamme
- Department of Microbiology and Immunology, Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven-University of LeuvenLeuven, Belgium; Center for Global Health and Tropical Medicine, Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de LisboaLisbon, Portugal
| | - Kristien Verdonck
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano HerediaLima, Peru; Department of Public Health, Institute of Tropical Medicine AntwerpAntwerp, Belgium
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Abstract
Adult T-cell leukaemia/lymphoma (ATLL) is a mature T-cell neoplasm of post-thymic lymphocytes aetiologically linked to the human T-cell lymphotropic virus, HTLV-I, and with a distinct geographical distribution. The disease manifests with leukaemia in greater than two thirds of patients, while the remaining patients have a lymphomatous form. According to the disease manifestations, various forms which differ in clinical course and prognosis have been recognised: acute, chronic, smouldering and lymphoma. Organomegaly, skin involvement, circulating atypical lymphocytes ("flower" cells) with a CD4+ CD25+ phenotype and hypercalcaemia are the most common disease features. The diagnosis should be based on a constellation of clinical features and laboratory investigations. The latter comprise: lymphocyte morphology, immunophenotype, histology of the tissues affected in the pure lymphoma forms and serology or DNA analysis for HTLV-I. The differential diagnosis of ATLL includes other mature T-cell neoplasms such as T-cell prolymphocytic leukaemia (T-PLL), Sézary syndrome (SS), peripheral T-cell lymphomas and occasionally healthy carriers of the virus or Hodgkin disease. The clinical course is aggressive with a median survival of less than 12 months in the acute and lymphoma forms. Despite major advances in understanding the pathogenesis of the disease, management of these patients remains a challenge for clinicians as they do not respond or achieve only transient responses to therapies used in high-grade lymphomas. The use of antiretroviral agents such as zidovudine in combination with interferon-alpha, with or without concomitant chemotherapy, has shown activity in this disease with improvement in survival and response rate. Consolidation with high dose therapy and autologous or allogeneic stem-cell transplantation should be considered in young patients.
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Affiliation(s)
- E Matutes
- Haemato-Oncology Unit, The Institute of Cancer Research/Royal Marsden NHS Trust, London, UK.
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Matsuoka M, Jeang KT. Human T-cell leukaemia virus type 1 (HTLV-1) infectivity and cellular transformation. Nat Rev Cancer 2007; 7:270-80. [PMID: 17384582 DOI: 10.1038/nrc2111] [Citation(s) in RCA: 608] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It has been 30 years since a 'new' leukaemia termed adult T-cell leukaemia (ATL) was described in Japan, and more than 25 years since the isolation of the retrovirus, human T-cell leukaemia virus type 1 (HTLV-1), that causes this disease. We discuss HTLV-1 infectivity and how the HTLV-1 Tax oncoprotein initiates transformation by creating a cellular environment favouring aneuploidy and clastogenic DNA damage. We also explore the contribution of a newly discovered protein and RNA on the HTLV-1 minus strand, HTLV-1 basic leucine zipper factor (HBZ), to the maintenance of virus-induced leukaemia.
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Affiliation(s)
- Masao Matsuoka
- Laboratory of Virus Immunology, Institute for Virus Research, Kyoto University, Japan
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Sagara Y, Inoue Y, Ohshima K, Kojima E, Utsunomiya A, Tsujimura M, Shiraki H, Kashiwagi S. Antibody to the central region of human T-lymphotropic virus type 1 gp46 is associated with the progression of adult T-cell leukemia. Cancer Sci 2007; 98:240-5. [PMID: 17297657 PMCID: PMC11160094 DOI: 10.1111/j.1349-7006.2006.00370.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) is an etiologic agent of adult T-cell leukemia/lymphoma (ATL). HTLV-1 is spread by cell-to-cell transmission via the gp46-197 region, Asp197 to Leu216, on the envelope protein gp46. In the present study, we revealed a positive correlation between the appearance of an antibody recognizing the gp46-197 region (anti-gp46-197 antibody) and the severity of ATL. The prevalence and titer of the anti-gp46-197 antibody were found to be elevated along with the progression of ATL. In serial samples obtained from a single patient, the anti-gp46-197 antibody was detected before treatment in acute phase, then diminished after allogeneic bone marrow transplantation, to which the patient had a complete response. However, the antibody appeared again before a relapse, along with an increase of the serum-soluble interleukin-2 receptor level and proviral load. The results from the other six patients also indicate that seroconversion of this antibody was synchronized with the deterioration of ATL. Taken together, the findings indicate that the anti-gp46-197 antibody may be a novel beacon for gauging the efficacy of therapeutic approaches to ATL, and a survey of this antibody would be useful for identifying asymptomatic carriers infected with HTLV-1 who are at high risk of developing ATL.
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MESH Headings
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Disease Progression
- Epitopes/immunology
- Gene Products, env/chemistry
- Gene Products, env/immunology
- Humans
- Leukemia-Lymphoma, Adult T-Cell/epidemiology
- Leukemia-Lymphoma, Adult T-Cell/immunology
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Leukemia-Lymphoma, Adult T-Cell/virology
- Prevalence
- Recurrence
- Retroviridae Proteins, Oncogenic/chemistry
- Retroviridae Proteins, Oncogenic/immunology
- Treatment Outcome
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Affiliation(s)
- Yasuko Sagara
- Department of Research, Fukuoka Red Cross Blood Center, 1-2-1 Kamikoga, Chikushino, Fukuoka 818-8588, Japan.
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Matsuoka M. Human T-cell leukemia virus type I (HTLV-I) infection and the onset of adult T-cell leukemia (ATL). Retrovirology 2005; 2:27. [PMID: 15854229 PMCID: PMC1131926 DOI: 10.1186/1742-4690-2-27] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Accepted: 04/26/2005] [Indexed: 11/13/2022] Open
Abstract
The clinical entity of adult T-cell leukemia (ATL) was established around 1977, and human T-cell leukemia virus type 1 (HTLV-I) was subsequently identified in 1980. In the 25 years since the discovery of HTLV-I, HTLV-I infection and its associated diseases have been extensively studied, and many of their aspects have been clarified. However, the detailed mechanism of leukemogenesis remains unsolved yet, and the prognosis of ATL patients still poor because of its resistance to chemotherapy and immunodeficiency. In this review, I highlight the recent progress and remaining enigmas in HTLV-I infection and its associated diseases, especially ATL.
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Affiliation(s)
- Masao Matsuoka
- Institute for Virus Research, Kyoto University, Kyoto 606-8507, Japan.
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Prates V, Cobos M, Bouzas B, Napal J, Bordone J, Milone J. The first report of familial adult T-cell leukemia/lymphoma in Argentina. Leuk Lymphoma 2000; 37:225-7. [PMID: 10721791 DOI: 10.3109/10428190009057650] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Here we describe two Caucasian brothers who developed adult T-cell leukemia/lymphoma (ATLL), within a short period of time. These two patients have never left Argentina. Their parents are dead and according to the family history it is possible that the mother may have been affected by spastic paraparesis. The daughters reported that their mother had suffered from increasing difficulty in walking for many years which finally made it impossible for to her walk. There are no other data to support the presumptive diagnosis. One of the patients presented with acute disease while the other had a lymphoma type disorder. Both were positive for HTLV 1. The first patient died with disease progression ten months after diagnosis and the second is in partial remission 13 months after diagnosis. Immunophenotyping showed CD4+, CD5+, CD3+, CD2+, CD8 (-). Two asymptomatic brothers with positive HTLV 1 serology were detected. This is the first family case that has been reported in Argentina.
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Affiliation(s)
- V Prates
- Instituto de Trasplante de Médula Osea, Fundación Mainetti, La Plata, Argentina
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Takatsuki K, Matsuoka M, Yamaguchi K. Adult T-cell leukemia in Japan. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1996; 13 Suppl 1:S15-9. [PMID: 8797698 DOI: 10.1097/00042560-199600001-00004] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Adult T-cell leukemia (ATL) was first reported in Japan, where it has a high incidence in the southwestern region. The retrovirus, human T-lymphotropic virus type I (HTLV-I), is found to be the causative agent of ATL. In ATL-endemic areas, the rate of HTLV-I carriers is high. A definite diagnosis of ATL is based on the presence of HTLV-I proviral DNA in the tumor cell DNA. ATL cells originate from the CD4 subset of peripheral T cells. ATL shows diverse clinical features but can be divided into four subtypes: the acute, chronic, smoldering, and lymphoma types. Chemotherapy is not effective; the acute and lymphoma types have a poor prognosis. Familial occurrence of ATL is common. HTLV-I infection is caused by transmission of live infected lymphocytes from mother to child, or from man to woman, or by blood transfusion.
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Affiliation(s)
- K Takatsuki
- Kumamoto University School of Medicine, Japan
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Matutes E, Spittle MF, Smith NP, Eady RA, Catovsky D. The first report of familial adult T-cell leukaemia lymphoma in the United Kingdom. Br J Haematol 1995; 89:615-9. [PMID: 7734362 DOI: 10.1111/j.1365-2141.1995.tb08371.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
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 Caribbean only once. Both patients were HTLV-1 seropositive, as was their mother; their father and brother were negative. The older sibling had the lymphoma form of ATLL, whilst the younger had chronic ATLL. The former was unresponsive to chemotherapy and died of progressive disease; the 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 from mother to child and documents the development of ATLL in second-generation Caribbean immigrants.
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Affiliation(s)
- E Matutes
- Academic Department of Haematology and Cytogenetics, Royal Marsden Hospital, London
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Araki S, Mochizuki M, Yamaguchi K, Watanabe T, Ono A, Yoshimura K, Shirao M, Miyata N. Familial clustering of human T lymphotropic virus type 1 uveitis. Br J Ophthalmol 1993; 77:747-8. [PMID: 8280695 PMCID: PMC504641 DOI: 10.1136/bjo.77.11.747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- S Araki
- Miyata Eye Hospital, Miyazaki, Japan
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Egawa K, Johno M, Hayashibara T, Ono T. Familial occurrence of crusted (Norwegian) scabies with adult T-cell leukaemia. Br J Dermatol 1992; 127:57-9. [PMID: 1637698 DOI: 10.1111/j.1365-2133.1992.tb14829.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- K Egawa
- Department of Dermatology, Kumamoto University Medical School, Japan
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Sanada I, Yamaguchi K, Yoshida M, Ishii T, Tsukamoto A, Sato M, Obata S, Shido T. Adult T-cell leukemia in spouses. Jpn J Cancer Res 1989; 80:401-4. [PMID: 2502513 PMCID: PMC5917751 DOI: 10.1111/j.1349-7006.1989.tb02326.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A married couple who developed adult T-cell leukemia (ATL) is described. The husband presented with acute ATL and died soon after admission in spite of aggressive chemotherapy, and his wife, who is diagnosed as smoldering ATL, has been followed in the out-patient clinic. The couple had serum antibodies against human T-cell leukemia virus type I (HTLV-I) and the monoclonal integration of HTLV-I proviral DNA in their lymphocytes. The patients described represent the first reported example of ATL in a married couple.
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Affiliation(s)
- I Sanada
- Department of Internal Medicine, Kumamoto National Hospital
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