BACKGROUND: Adult T-cell leukemia/lymphoma (ATL) is an aggressive lymphoproliferative disorder caused by human T-cell leukemia virus type I (HTLV-I). HTLV-I is endemic in southern Japan, the Caribbean, Central and South America, certain areas of Africa, and the southeastern United States. In the Middle East, North East Iran, particularly the region of Mashhad, has been recognized as an endemic region. CASE REPORTS: In this report, the first two cases of ATL diagnosed in Lebanon are described. The first patient of Lebanese origin presented with acute ATL. The second patient of Romanian origin developed acute ATL in early relapse after autologous transplantation for ATL. Both patients had lymphocytosis, severe hypercalcemia, and CD25+ T-cell immunophenotype on peripheral blood. In both patients, HTLV-I serology was positive by enzyme-linked immunosorbent assay and confirmed by Western blot and HTLV-I oncoprotein Tax expression was documented in the leukemic cells. Upon screening, seven direct family members of the first patient were HTLV-I positive; four of them were regular blood donors. CONCLUSIONS: Screening blood donors for HTLV-I seropositivity is not currently performed in Lebanon. A large screening study in Lebanon is needed to confirm whether South Lebanon is a new endemic region for HTLV-I infection and to recommend mandatory screening of blood donors for HTLV-I infection.
BACKGROUND: Adult T-cell leukemia/lymphoma (ATL) is an aggressive lymphoproliferative disorder caused by human T-cell leukemia virus type I (HTLV-I). HTLV-I is endemic in southern Japan, the Caribbean, Central and South America, certain areas of Africa, and the southeastern United States. In the Middle East, North East Iran, particularly the region of Mashhad, has been recognized as an endemic region. CASE REPORTS: In this report, the first two cases of ATL diagnosed in Lebanon are described. The first patient of Lebanese origin presented with acute ATL. The second patient of Romanian origin developed acute ATL in early relapse after autologous transplantation for ATL. Both patients had lymphocytosis, severe hypercalcemia, and CD25+ T-cell immunophenotype on peripheral blood. In both patients, HTLV-I serology was positive by enzyme-linked immunosorbent assay and confirmed by Western blot and HTLV-I oncoprotein Tax expression was documented in the leukemic cells. Upon screening, seven direct family members of the first patient were HTLV-I positive; four of them were regular blood donors. CONCLUSIONS: Screening blood donors for HTLV-I seropositivity is not currently performed in Lebanon. A large screening study in Lebanon is needed to confirm whether South Lebanon is a new endemic region for HTLV-I infection and to recommend mandatory screening of blood donors for HTLV-I infection.
Authors: Zaher K Otrock; Jad Saab; Georges Aftimos; Fady Nasr; Fadi S Farhat; Saad Khairallah; Gérard Abadjian; Marwan Ghosn; Hassan Sidani; Ahmad Ibrahim; Ayman Tawil; Claude Ghorra; Zarouhie Meguerian; Walid Mokaddem; Walid Dayeh; Ziad Salem; Georges Chahine; Nizar Bitar; Anas Mugharbel; Joseph Makdessi; Christina Khater; Mirna El Hajj; Dany Abi Gerges; Charles Sfeir; Joseph Kattan; Khaled Ibrahim; Michel Saade; Hussein Sadek; Rami A Mahfouz; Mohamed A Kharfan-Dabaja; Ghazi Zaatari; Ali Bazarbachi Journal: Pathol Oncol Res Date: 2013-05-08 Impact factor: 3.201