Clinical and laboratory characterization of adult T-cell leukemia/lymphoma in patients from Salvador, Bahia

ABSTRACT

ATLL is a malignant and aggressive leukemia whose survival time is limited. It is known that 5% of individuals infected with HTLV-1, after many years of latency, may develop this disease. The mechanisms by which the evolution of clinical conditions occurs are unknown, and in Brazil there are few studies about ATLL, this some important themes will be addressed in this study. Thus, the objective of this study is to characterize the epidemiological and immunophenotypic profile of patients diagnosed with ATLL, attended at an oncohematological reference center in Salvador, Bahia, in the period between 2010-2018. The methodology consisted of a descriptive, retrospective of time series study, which cases of ATLL were collected from reports belonging a reference laboratory and of medical reports available from Com-HUPES. These data were treated and analyzed statistically, being observed that the majority of cases were female and that a large part have the most aggressive clinical condition Although the literature reports that ATLL clinical condition are always considered as severe, in this study it was observed that patients can achieve long survival in good clinical conditions, according to the treatment administered. In view of the available results, it is possible to conclude that exist a broad distinction between the clinical and molecular forms, being may be an important indicator of the evolution of ATLL.

RESUMO

Leucemia/linfoma de células T do adulto (L/LTA) é uma leucemia maligna e agressiva, cujo tempo de sobrevivência é limitado. Sabe-se que 5% dos indivíduos infectados pelo vírus T-linfotrópico humano tipo 1 (HTLV-1), após muitos anos de latência, podem desenvolver essa doença. Os mecanismos pelos quais ocorre a evolução das condições clínicas são desconhecidos, e no Brasil existem poucos estudos sobre L/LTA, alguns temas importantes serão abordados neste estudo. Assim, o objetivo deste estudo é caracterizar o perfil epidemiológico e imunofenotípico dos pacientes com diagnóstico de L/LTA, atendidos em um centro de referência em oncohematologia em Salvador, Bahia, no período de 20102018. A metodologia consistiu em um estudo descritivo e retrospectivo de séries temporais, cujos casos de L/LTA foram coletados em laudos pertencentes a um laboratório de referência e em laudos médicos disponibilizados pelo Com-HUPES. Esses dados foram tratados e analisados estatisticamente, sendo observado que a maioria dos casos era do sexo feminino e que grande parte apresenta o quadro clínico mais agressivo. Apesar de a literatura relatar que as condições clínicas do L/LTA são sempre consideradas graves, neste estudo observou-se que os pacientes podem alcançar longa sobrevida em boas condições clínicas, de acordo com o tratamento administrado. Diante dos resultados disponíveis, é possível concluir que existe uma ampla distinção entre as formas clínica e molecular, podendo ser um importante indicador da evolução da L/LTA.

Keywords:

Adult T-cell leukemia-lymphoma - HTLV-1 - Immunophenotyping - treatment - survival

Descritores:

Sobrevivência - Leucemia-linfoma de células T adultas - Vírus T-linfotrópico humano tipo 1 - Imunofenotipagem - Resultado do tratamento.

Publikationsverlauf

Eingereicht: 17. August 2020

Angenommen: 02. Februar 2021

Artikel online veröffentlicht:
05. März 2021

• REFERENCES

• Oliveira Pedro Dantas, Farre Lourdes, Bittencourt Achiléa Lisboa. Adult T - Cell Leukemia/Lymphoma. Revista Da Associação Médica Brasileira , v 62 , n [phone] 2016;
• Pombo-De-Oliveira Maria S.. et al Adult T-cell leukemia/lymphoma and cluster of HTLV-I associated diseases in brazilian settings. Leukemia & Lymphoma , v 42 , n 1–2 135-144 2001;
• Matsuoka Masao. Human T-cell leukemia virus type I (HTLV-I) infection and the onset of adult t-cell leukemia (ATLL). Retrovirology , v 2 , n (01) 27 2005;
• Clark Georgina. et al CD nomenclature 2015: human leukocyte. Journal of Immunology , v 195: 4555-4563 2015;
• Bittencourt Achiléa L.. et al Adult T-cell leukemia/ lymphoma (ATL) presenting in the skin: clinical, histological and immunohistochemical features of 52 cases. Acta Oncologica , v 48 , n [phone] 2009;
• Akbarin Mohammad Mehdi. et al Evaluation of the role of tax, hbz, and HTLV-1 proviral load on the survival of ATLL patients. Blood Research , v 52 , n [phone] 2017;
• Tsukasaki Kunihiro. et al Definition, prognostic factors, treatment, and response criteria of adult t-cell leukemia-lymphoma: a proposal from an international consensus meeting. Journal of Clinical Oncology , v 27 , n [phone];
• Paiva Arthur, Casseb Jorge. Origin and prevalence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) among indigenous populations in the americas. Revista do Instituto de Medicina Tropical de São Paulo , v 57 , n (01) 01-14 2015;
• Chen Jing. et al Autocrine/paracrine cytokine stimulation of leukemic cell proliferation in smoldering and chronic adult T-cell leukemia. Blood , v 116 , n (26) 5948-5956 2010;
• Yamagishi Makoto, Watanabe Toshiki. Molecular hallmarks of adult T cell leukemia. Frontiers in Microbiology , v 3: 334 2012;
• Shimoyama Masanori. lymphoma study group (1984-87). Diagnostic criteria and classification of clinical subtypes of adult T-cell leukemialymphoma: a report from the lymphoma study group (1984-87). British Journal of Haematology 79 , n [phone] 1991;
• Arisawa Kokichi. et al Evaluation of adult Tcell leukemia/lymphoma incidence and its impact on non-Hodgkin lymphoma incidence in southwestern japan. International Journal of Cancer , v 85 , n [phone] 2000;
• Carneiro-Proietti A. B.. et al Infecção e doença pelos vírus linfotrópicos humanos de células T (HTLV-I/II) no Brasil. 2002
• HTLV. Carneiro-Proietti, A. B. 6. Belo Horizonte: FUNDAÇÃO HEMOMINAS; 2015: 651 il. ; - (Cadernos Hemominas; v. 16)
• Mota Augusto. et al A case-control study of HTLVinfection among blood donors in Salvador, Bahia, Brazil-associated risk factors and trend towards declining prevalence. Revista Brasileira de Hematologia e Hemoterapia , v 28 , n [phone] 2006;
• Bittencourt Achiléa L., Farré Lourdes. Adult T-cell leukemia/lymphoma. Anais Brasileiros de Dermatologia , v 83 , n [phone] 2008;
• Yamagishi Makoto. et al Polycomb-mediated loss of mir-31 activates nik-dependent nf-?b pathway in adult t cell leukemia and other cancers. Cancer Cell , v 21 , n [phone] 2012;
• Malpica Luis. et al epidemiology, clinical features, and outcome of HTLV-1-related ATLL in an area of prevalence in the united states. Blood Advances , v 2 , n [phone] 2018;
• Borducchi Davimar Miranda Maciel, Kerbauy José, De Oliveira J. S. R.. Linfoma/leucemia de células T do adulto. Revista Da Associação Médica Brasileira , v 45 , n (01) 63-70 1999;
• De Oliveira Ms Pombo. et al Adult T-cell leukaemia/ lymphoma in brazil and its relation to htlv-1. The Lancet , v 336 , n (8721) 987-990 1999;
• Bazarbachi Ali. et al Meta-analysis on the use of zidovudine and interferon-alfa in adult t-cell leukemia/lymphoma showing improved survival in the leukemic subtypes. Journal Of Clinical Oncology , v 28 , n (27) 4177-4183 2010;
• Vallve Maria de Lourdes Farre. et al patogênese da leucemia/linfoma de células T do adulto (ATL). 2009
• Kozako Tomohiro. et al Reduced frequency, diversity, and function of human t cell leukemia virus type 1-specific cd8+ T cell in adult T cell leukemia patients. The Journal of Immunology , v 177 , n [phone] 2006;
• Laher Abdullah E.. et al HTLV-1, ATLL, refractory hypercalcaemia and HIV-1 co-infection. Oxford Medical Case Reports , v 2018 , n (01) omx081 2018;