Adult T-cell leukemia: a review of epidemiological evidence
Adult T-cell leukemia (ATL) is an aggressive T-cell malignancy caused by human T-cell leukemia virus type I (HTLV-1) infection and often occurs in HTLV-1-endemic areas, such as southwestern Japan, the Caribbean islands, Central and South America, Intertropical Africa, and Middle East. To date, many...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2012-09-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fmicb.2012.00322/full |
| _version_ | 1828159769476595712 |
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| author | Masako eIwanaga Toshiki eWatanabe Kazunari eYamaguchi |
| author_facet | Masako eIwanaga Toshiki eWatanabe Kazunari eYamaguchi |
| author_sort | Masako eIwanaga |
| collection | DOAJ |
| description | Adult T-cell leukemia (ATL) is an aggressive T-cell malignancy caused by human T-cell leukemia virus type I (HTLV-1) infection and often occurs in HTLV-1-endemic areas, such as southwestern Japan, the Caribbean islands, Central and South America, Intertropical Africa, and Middle East. To date, many epidemiological studies have been conducted to investigate the incidence of ATL among general population or HTLV-1 carriers and to identify a variety of laboratory, molecular, and host-specific markers to be possible predictive factors for developing ATL because HTLV-1 infection alone is not sufficient to develop ATL. This literature review focuses on the epidemiology of ATL and the risk factors for the development of ATL from HTLV-1 carriers, while keeping information on the epidemiology of HTLV-1 to a minimum. The main lines of epidemiological evidence are: (1) ATL occurs mostly in adults, at least 20–30 years after the HTLV-1 infection, (2) age at onset differs across geographic areas: the average age in the Central and South America (around 40 years old) is younger than that in Japan (around 60 years old), (3) ATL occurs in those infected in childhood, but seldom occurs in those infected in adulthood, (4) male carriers have about a 3–5 fold higher risk of developing ATL than female, (5) the estimated life-time risk of developing ATL in HTLV-1 carriers is 6–7% for men and 2–3% for women in Japan, (6) a low anti-Tax reactivity, a high soluble interleukin-2 receptor level, a high anti-HTLV-1 titer, and high levels of circulating abnormal lymphocytes and white blood cell count are accepted risk factors for the development of ATL, and (7) a higher proviral load (more than 4 copies/100 peripheral blood mononuclear cells) is an independent risk factor for progression of ATL. Nevertheless, the current epidemiological evidence is insufficient to fully understand the relationship between HTLV-1 infection and ATL. Further well-designed epidemiological studies are needed. |
| first_indexed | 2024-04-12T00:06:18Z |
| format | Article |
| id | doaj.art-8471db30b75c4635a02fcc1a99a9dda9 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-04-12T00:06:18Z |
| publishDate | 2012-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-8471db30b75c4635a02fcc1a99a9dda92022-12-22T03:56:05ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2012-09-01310.3389/fmicb.2012.0032229018Adult T-cell leukemia: a review of epidemiological evidenceMasako eIwanaga0Toshiki eWatanabe1Kazunari eYamaguchi2 Graduate School of Public Health, Teikyo UniversityGraduate School of Frontier Sciences, The University of TokyoDepartment of Safety Research on Blood and Biologics, National Institute of Infectious DiseasesAdult T-cell leukemia (ATL) is an aggressive T-cell malignancy caused by human T-cell leukemia virus type I (HTLV-1) infection and often occurs in HTLV-1-endemic areas, such as southwestern Japan, the Caribbean islands, Central and South America, Intertropical Africa, and Middle East. To date, many epidemiological studies have been conducted to investigate the incidence of ATL among general population or HTLV-1 carriers and to identify a variety of laboratory, molecular, and host-specific markers to be possible predictive factors for developing ATL because HTLV-1 infection alone is not sufficient to develop ATL. This literature review focuses on the epidemiology of ATL and the risk factors for the development of ATL from HTLV-1 carriers, while keeping information on the epidemiology of HTLV-1 to a minimum. The main lines of epidemiological evidence are: (1) ATL occurs mostly in adults, at least 20–30 years after the HTLV-1 infection, (2) age at onset differs across geographic areas: the average age in the Central and South America (around 40 years old) is younger than that in Japan (around 60 years old), (3) ATL occurs in those infected in childhood, but seldom occurs in those infected in adulthood, (4) male carriers have about a 3–5 fold higher risk of developing ATL than female, (5) the estimated life-time risk of developing ATL in HTLV-1 carriers is 6–7% for men and 2–3% for women in Japan, (6) a low anti-Tax reactivity, a high soluble interleukin-2 receptor level, a high anti-HTLV-1 titer, and high levels of circulating abnormal lymphocytes and white blood cell count are accepted risk factors for the development of ATL, and (7) a higher proviral load (more than 4 copies/100 peripheral blood mononuclear cells) is an independent risk factor for progression of ATL. Nevertheless, the current epidemiological evidence is insufficient to fully understand the relationship between HTLV-1 infection and ATL. Further well-designed epidemiological studies are needed.http://journal.frontiersin.org/Journal/10.3389/fmicb.2012.00322/fullEpidemiologyHTLV-1ATLAdult T-cell leukemiahuman T-cell leukemia virus type I |
| spellingShingle | Masako eIwanaga Toshiki eWatanabe Kazunari eYamaguchi Adult T-cell leukemia: a review of epidemiological evidence Frontiers in Microbiology Epidemiology HTLV-1 ATL Adult T-cell leukemia human T-cell leukemia virus type I |
| title | Adult T-cell leukemia: a review of epidemiological evidence |
| title_full | Adult T-cell leukemia: a review of epidemiological evidence |
| title_fullStr | Adult T-cell leukemia: a review of epidemiological evidence |
| title_full_unstemmed | Adult T-cell leukemia: a review of epidemiological evidence |
| title_short | Adult T-cell leukemia: a review of epidemiological evidence |
| title_sort | adult t cell leukemia a review of epidemiological evidence |
| topic | Epidemiology HTLV-1 ATL Adult T-cell leukemia human T-cell leukemia virus type I |
| url | http://journal.frontiersin.org/Journal/10.3389/fmicb.2012.00322/full |
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