Pombo-de-Oliveira M S, Carvalho S M, Borducchi D, Dobbin J, Salvador J, Correa R B, Moellman A, Loureiro P, Chiattone C, Rios M
Cell Marker Laboratory-Department of Hematology of Instituto Nacional de Cancer, Hematologia Clinica, Praça Cruz Vermelha, 23, 7th floor, CEP 20 230 030-Rio de Janeiro, Brazil.
Leuk Lymphoma. 2001 Jun;42(1-2):135-44. doi: 10.3109/10428190109097685.
We studied the transmission routes of human T-cell lymphotropic virus type I (HTLV-I) within families of 82 Brazilian patients diagnosed with adult T-cell leukaemia/lymphoma (ATL). Diagnosis of ATL in 43 male and 39 female patients was based on clinical and laboratory criteria of T-cell malignancy and detection of HTLV-I monoclonal integration. Samples were tested for HTLV antibodies and infection was confirmed as HTLV-I by Western Blot and/or polymerase chain reaction (PCR) assays. Overall 26/37 (70%) of mothers, 24/37 (65%) of wives, 8/22 (36%) of husbands, 34/112 (30%) of siblings and 10/82 (12%) offspring were HTLV-I infected. In 11 ATL patients, mothers were repeatedly HTLV-I seronegative, but HTLV-I pol or tax sequences were detected in 2 out of 6 cases tested by PCR. ATL patients with seronegative mothers related the following risk factors for HTLV-I infection: 6 were breast-fed by surrogate mothers with unknown HTLV-I status, 4 had a sexually promiscuous behaviour and 1 had multiple blood transfusions at a young age. Familial aggregation of ATL and other HTLV-I associated diseases such as HTLV-I myelopathy (HAM/TSP) and or uveitis, ATL in sibling pairs or in multiple generations was seen in 9 families. There were 6 families with ATL and TSP sibling pairs. In 3 families at least one parent had died with lymphoma or presenting neurological diseases and 2 offspring with ATL. Further to the extent of vertical and horizontal transmission of HTLV-I infection within ATL families, our results demonstrate that mothers who provide surrogate breast-milk appear to be an important source of HTLV-I transmission and ATL development in Brazil.
我们研究了82名被诊断为成人T细胞白血病/淋巴瘤（ATL）的巴西患者家庭中I型人类嗜T细胞病毒（HTLV-I）的传播途径。43名男性和39名女性患者的ATL诊断基于T细胞恶性肿瘤的临床和实验室标准以及HTLV-I单克隆整合的检测。对样本进行了HTLV抗体检测，并通过蛋白质印迹法和/或聚合酶链反应（PCR）检测确认感染为HTLV-I。总体而言，37名母亲中有26名（70%）、37名妻子中有24名（65%）、22名丈夫中有8名（36%）、112名兄弟姐妹中有34名（30%）以及82名后代中有10名（12%）感染了HTLV-I。在11名ATL患者中，母亲多次HTLV-I血清学检测呈阴性，但通过PCR检测的6例中有2例检测到HTLV-I pol或tax序列。母亲血清学检测呈阴性的ATL患者与以下HTLV-I感染风险因素有关：6名由HTLV-I感染状况不明的代孕母亲母乳喂养，4名有性乱行为，1名在年轻时接受过多次输血。在9个家庭中发现了ATL以及其他HTLV-I相关疾病如HTLV-I脊髓病（HAM/TSP）和/或葡萄膜炎的家族聚集现象，包括同胞对或多代人中出现ATL。有6个家庭存在ATL和TSP同胞对。在3个家庭中，至少有一位父母死于淋巴瘤或患有神经系统疾病，并有2名后代患有ATL。除了HTLV-I感染在ATL家庭中的垂直和水平传播程度外，我们的结果表明，在巴西，提供代孕母乳的母亲似乎是HTLV-I传播和ATL发展的一个重要来源。
