Título

EDITORIAL

JOURNAL OF THE FACULTY OF HUMAN MEDICINE 2020 - Universidad Ricardo Palma
DOI 10.25176/RFMH.v20i2.2914

ADULT LYMPHOMA / LEUKEMIA T: PREVALENT ENTITY IN SOUTH AMERICA

LINFOMA/LEUCEMIA T DEL ADULTO : ENTIDAD PREVALENTE EN SUDAMERICA

Brady E. Beltran1, Jorge Castillo2,3

1Lymphoma Unit - Medical Oncology Service. Social Security National Hospital Edgardo Rebagliati Martins, Lima-Perú.
2Bing Center for Waldenstrom Macroglobulinemia.
3Division of Hematological Malignancies, Dana-Farber Cancer Institute.

Adult T - lymphoma / leukemia is an aggressive T lymphoproliferative entity associated retrovirus HTLV-1- T.

HTLV-1 infection is endemic in Japan, the Caribbean, Africa, South America, and the Middle East. In South America, we have Peru, Brazil, Colombia and Chile.

Peru is endemic for this virus(1-3). The prevalence of retroviruses in Europe and the USA. USA It is less than 1% but in Peru it is estimated that around 3% of the healthy adult population is a carrier of the retrovirus(4,5).

From Chile, there have been several ATLL reports since 1992 by Dra. Cabrera et al.(6,7,8).

Other diseases caused by retroviruses include tropical spastic paraparesis, uveitis, infectious dermatitis, and other rheumatologic, psychiatric, and infectious disorders(9).

Only 2% to 4% of virus carriers will develop ATLL(10). The viral genes involved in the malignant transformation are Tax and HBZ(11,12).

Five clinical types are identified in this disease: latent, chronic, cutaneous, lymphomatous, and acute. However, the acute and lymphomatous forms are the most aggressive and also the most prevalent.

As to prognosis, the poor prognosis factors are: clinical stage, performance status, age, albumin, and soluble IL-2 receptor(13).

The survival of the acute forms can be 2 months, while the lymphomatous forms can have a survival time of around 9 months.

Treatment for leukemic forms is Interferon alfa and zidovudine; the lymphomatous form responds to chemotherapy(14,15). Allogeneic transplantation may be the only curative form of the disease.

In this issue of the journal, a complete review of this entity is presented by Dra. Cabrera et al.

Correspondence: Brady E. Beltrán.
Address: Av. Edgardo Rebagliati 490, Jesús María 15072, Lima-Perú.
Telephone: +51 999539061
E-mail: bgbrady@hotmail.com

BIBLIOGRAPHIC REFERENCES

    1. Carrasco A.,Beltrán B et al.clinicalandphenotypic characteristics of adult t-cell leukemia / lymphoma – report of 36 cases in lima-perú. proceeding book eha 2001,poster.
    2. Pimentel P, Beltrán B, Carrasco A. clinical characteristics of lymphomatous form of adult t cell lymphoma-leukemia in peru proceedings book asco 2005, abstract 6728.
    3. Beltran B, Carrasco A. clinical outcomes in adult t leukemia / lymphoma: report of 55 cases from peru. proceeding book ash 2005, abstract 479.
    4. Sanchez-Palacios C, et al. Seroprevalence and risk factors for human t-cell lymphotropic virus (htlv-i) infection among ethnically and geographically diverse peruvian women. International Journal of infectious diseases 2003; 7: 132–137.
    5. Alarcón Jo, et al. High endemicity of human t-cell lymphotropic virus type 1 among pregnant women in peru. Journal of acquired immune deficiency syndromes 2006; 42: 604–609.
    6. Cabrera me, gray am, cartier l, et al. simultaneous adult t-cell leukemia/lymphoma and sub-acute polyneuropathy in a patient from Chile. Leukemia 1991; 5: 350–353.
    7. Cabrera Mec, Majlis AL, Labra SG, et al. Estudio inmunologico de enfermedades linfoproliferativas. rev me´d chile 1992; 120: 772–777.
    8. Cabrera ME, Labra S, Catovsky D, et al. Htlv-i positive adult t-cell leukaemia/lymphoma (atll) in Chile. Leukemia 1994; 8: 1763–1767.
    9. Proietti FA, Carneiro-Proietti AB, Catalan-Soares BC, et al. Oncogene. global epidemiology of htlv-i infection and associated diseases 2005 ;24(39):6058-68.
    10. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans, volume 100B. Biological Agents. Lyon (France): IARC; 2012. Available at: http://monographs.iarc.fr/ENG/ Monographs/vol100B
    11. Brand H, Alves JGB, Pedrosa F, Lucena-Silva N. Leucemia de células T do adulto. Rev Bras Hematol Hemoter. 2009; 31(5):375-83.
    12. 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.
    13. Katsuya H, Yamanaka T, Ishitsuka K, Utsunomiya A, Sasaki H, Hanada S, et al. Prognostic index for acute- and lymphoma-type adult T-cell leukemia/ lymphoma. J Clin Oncol. 2012; 30(14):1635-40 12
    14. Ministério da Saúde – Secretaria de Vigilância da Saúde. Portaria n. 54 de 18/07/2016 – Aprova o Protocolo de Uso da Zidovudina para Tratamento do Adulto com Leucemia/Linfoma Associação ao Vírus HTLV-1. Diário Oficial da União. 2016. Available in: http://bvsms.saude.gov.br/bvs/saudelegis/ svs/2016/prt0054_18_07_2016.html.
    15. Bazarbachi A, Plumelle Y, Carlos Ramos J, Tortevoye P, Otrock Z, Taylor G, 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. J Clin Oncol. 2010; 28(27):4177-83.

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