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Risk stratification of adult T-cell leukemia/lymphoma using immunophenotyping.
- Source :
-
Cancer medicine [Cancer Med] 2017 Jan; Vol. 6 (1), pp. 298-309. Date of Electronic Publication: 2016 Dec 30. - Publication Year :
- 2017
-
Abstract
- Adult T-cell leukemia/lymphoma (ATL), a human T-lymphotropic virus type 1 (HTLV-1)-associated disease, has a highly variable clinical course and four subtypes with therapeutic and prognostic implications. However, there are overlapping features between ATL subtypes and between ATL and nonmalignant (non-ATL) HTLV-1 infection complicating diagnosis and prognostication. To further refine the diagnosis and prognosis of ATL, we characterized the immunophenotype of HTLV-1-infected cells in ATL and non-ATL. A retrospective study of peripheral blood samples from 10 HTLV-1-uninfected subjects (UI), 54 HTLV-1-infected patients with non-ATL, and 22 with ATL was performed using flow cytometry. All patients with ATL had CD4 <superscript>+</superscript>  CCR4 <superscript>+</superscript>  CD26 <superscript>-</superscript> immunophenotype and the frequency of CD4 <superscript>+</superscript>  CCR4 <superscript>+</superscript>  CD26 <superscript>-</superscript> T cells correlated highly significantly with the proviral load in non-ATL suggesting CD4 <superscript>+</superscript>  CCR4 <superscript>+</superscript>  CD26 <superscript>-</superscript> as a marker of HTLV-1-infected cells. Further immunophenotyping of CD4 <superscript>+</superscript>  CCR4 <superscript>+</superscript>   CD26 <superscript>-</superscript> cells revealed that 95% patients with ATL had a CD7 <superscript>-</superscript> (≤30% CD7 <superscript>+</superscript> cells), whereas 95% HTLV+ non-ATL had CD7 <superscript>+</superscript> (>30% CD7 <superscript>+</superscript> cells) immunophenotype. All patients with aggressive ATL had a CCR7 <superscript>+</superscript> (≥30%), whereas 92% with indolent ATL and 100% non-ATL had a CCR7 <superscript>-</superscript> (<30%) immunophenotype. Patients with nonprogressing indolent ATL were CD127 <superscript>+</superscript> but those with progressive lymphocytosis requiring systemic therapy had a CD127 <superscript>-</superscript> (≤30%) immunophenotype. In summary, HTLV-1-infected cells have a CD4 <superscript>+</superscript>  CCR4 <superscript>+</superscript>  CD26 <superscript>-</superscript> immunophenotype. Within this population, CD7 <superscript>-</superscript> phenotype suggests a diagnosis of ATL, CCR7 <superscript>+</superscript> phenotype identifies aggressive ATL, while CCR7 <superscript>-</superscript> CD127 <superscript>-</superscript> phenotype identifies progressive indolent ATL.<br /> (© 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
CD4 Antigens metabolism
Diagnosis, Differential
Dipeptidyl Peptidase 4 metabolism
Female
HTLV-I Infections immunology
Humans
Leukemia-Lymphoma, Adult T-Cell immunology
Leukemia-Lymphoma, Adult T-Cell virology
Male
Middle Aged
Prognosis
Receptors, CCR4 metabolism
Young Adult
HTLV-I Infections diagnosis
Immunophenotyping methods
Leukemia-Lymphoma, Adult T-Cell diagnosis
T-Lymphocytes immunology
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 6
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28035765
- Full Text :
- https://doi.org/10.1002/cam4.928