Levine P H, Dosik H, Joseph E M, Felton S, Bertoni M A, Cervantes J, Moulana V, Miotti A B, Goberdhan L J, Lee S L, Daouad A, DaCosta M, Jaffe E S, Axiotis C A, Cleghorn F R, Kahn A, Welles S L
National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Int J Cancer. 1999 Mar 1;80(5):662-6. doi: 10.1002/(sici)1097-0215(19990301)80:5<662::aid-ijc5>3.0.co;2-i.
Adult T-cell leukemia/lymphoma (ATL), a rare outcome of infection with human T-lymphotropic virus (HTLV-I), is endemic in central Brooklyn, which has a large Caribbean migrant population. Previous studies have suggested that HTLV-I prevalence in central Brooklyn may be similar to that recorded in the Caribbean islands. We established a pilot 1-year surveillance program to identify cases of ATL in 7 of 10 hospitals serving the residents of 18 zip codes of central Brooklyn with a combined population of 1,184,670. Of the 6,198 in-patient beds in the catchment area, approximately 83% were covered. Twelve incident cases of ATL were ascertained, all among persons of Afro-Caribbean descent, indicating an annual incidence in African-Americans in this community of approximately 3.2/100,000 person-years. Unexplained hypercalcemia was the most useful screening method, identifying 3 of 5 patients not referred for possible ATL by a local hematologist. The female:male ratio was 3:1. The age pattern was different from that reported in the Caribbean Basin and closer to the pattern seen in Japan. Our study supports evidence that HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive surveillance program for this disease coupled with intervention efforts to reduce HTLV-I transmission are warranted.
