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Adult T-cell leukemia/lymphoma in HTLV-1 non-endemic regions

2023; Elsevier BV; Volume: 167; Linguagem: Inglês

10.1016/j.jcv.2023.105578

1873-5967

Carmen de Mendoza, Ariadna Rando‐Segura, Elisenda Miró, María José Pena, Iciar Rodríguez-Avial, Diego Ortega, Alejandro González‐Praetorius, Gabriel Reina, Ilduara Pintos, María José Pozuelo, Vincent Soriano, Enrique J. Calderón, Manuel Rodríguez‐Iglesias, Natalia Montiel, Toby C. Trujillo, Isabel Viciana, Teresa Cabezas, A. Lozano, Elisa Fernández-Fuertes, Juan Manuel Fernández, Féderico García, Rafael Benito, Sonia Algarate, María Ducons, Lourdes Roc, Celia Cifuentes, Victoria Fernández‐Baca, José Vicente Fernández-Montero, MD. Maciá, A. Hernández-Betancor, A. M. Martín, María José Mellado, Marta Hernández, A. López-Lirola, Juan Luís Gómez-Sirvent, Rodolfo Copado, M.E. Cano, S Rojo, José Marı́a Eiros Bouza, Manuel Rodríguez, César Gómez-Hernando, Alejandro González‐Praetorius, Ariadna Rando‐Segura, Lluís Force, Elisenda Miró, A. Cebollero, J.F. Delgado, G. Rodríguez-Laiz, Luis Fernández-Pereira, Antonio Aguilera, S. Pereira, Juan González‐García, Matilde Trigo, J. Diz, Marta García‐Campello, S. Cortizo, Salvador Pérez, Luís Morano, Gabriel Reina, M. Arazamendi, Y. Salicio, Estíbaliz Ugalde, M C Nieto, Paloma Liendo, Ane Josune Goikoetxea, María Dolores Ocete, José Manuel Ramos, Isabel Escribano, Silvia Sauleda, María Pirón, Ruperto González‐Pérez, Alberto Richart, Luisa Barea, Antonio Jiménez, Lidia Rodríguez Blanco, Lourdes Navarro, Oskar Ayerdi, Begoña Baza, Carmen Rodríguez, Jorge del Romero, Alicia Galar, Teresa Aldámiz, Miguel González Valeiro, Lester J. Pérez, Iciar Rodríguez-Avial, Luz Martín‐Carbonero, Mario Fernández‐Ruiz, Patricia Parra, Natalia Redondo, Tamara Ruiz‐Merlo, María José Pozuelo, Pablo Barreiro, Ana Treviño, Octavio Corral, Vincent Soriano, Ilduara Pintos, Víctor Moreno‐Torres, P. Carrizo, A. Huertas, J.A. Vargas-Núñez, Carmen de Mendoza,

Vector-Borne Animal Diseases

HTLV-1 infection is a neglected disease, despite producing neurological and lymphoproliferative severe illnesses and affect over 10 million people worldwide. Roughly 5% of HTLV-1 carriers develop Adult T-cell leukemia/lymphoma (ATLL), one of the most aggressive hematological malignancies.A national HTLV-1 register exists since 1989 in Spain, a non-endemic country with a large migrant flow from Latin America and Equatorial Africa, where HTLV-1 is endemic. The main features of all patients diagnosed with ATLL in Spain up to date are reported.A total of 451 cases of HTLV-1 infection had been reported in Spain until the end of year 2022. ATLL had been diagnosed in 35 (7.8%). The current average incidence of ATLL in Spain is of two cases per year. Women represent 57% of ATLL patients. Mean age at diagnosis was 47 years-old. Roughly 57% were Latin Americans and 26% Africans. At diagnosis, the majority presented with acute or lymphoma clinical forms. Survival was shorter than one year in most of them. Mean HTLV-1 proviral load was significantly greater in ATLL patients than in asymptomatic HTLV-1 carriers (2,305 vs 104 copies/104 PBMC). HTLV-1 subtyping in 6 ATLL patients found the 1a transcontinental variant (n = 4) and the Japanese variant (n = 2). All ATLL patients were negative for HIV-1, did not develop HTLV-1-associated myelopathy and were not transplant recipients.The rate of ATLL is very low in Spain and mostly associated to migrants from HTLV-1 endemic regions. Given the poor clinical outcome of ATLL, HTLV-1 testing should be performed at least once in all migrants coming from HTLV-1 endemic countries and in natives who have lived in or had sex partners from such regions.