Department of Dermatology, Professor Edgar Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil.
J Clin Virol. 2010 Aug;48(4):288-90. doi: 10.1016/j.jcv.2010.05.005. Epub 2010 Jun 11.
Infective dermatitis associated with HTLV-1 (IDH) is a severe childhood form of eczema that may progress to adult T-cell leukemia/lymphoma (ATL).
In this study, the presence of clinical and laboratory parameters suggestive of ATL was evaluated in a cohort of 30 patients with IDH.
Over a period of 33 months, the patients were submitted to three-monthly clinical evaluations, routine laboratory exams, full blood count and blood smears, and to six-monthly blood sampling for HTLV-1 proviral load determination. HTLV-1 proviral load was quantified using real-time TaqMan PCR assay.
Abnormal cells (Ably) were found in the peripheral blood smears of nine patients (30%), flower cells being detected in five of these cases (16.6%). The presence of Ably and flower cells was not associated with a higher proviral load in those patients.
This is the first report on the presence of flower cells in HTLV-1-infected children and adolescents. Furthermore, these cells have not previously been reported in IDH patients. The cases with flower cells probably represent precursory ATL cases, these patients being at a greater risk of developing ATL.
与 HTLV-1 相关的感染性皮炎（IDH）是一种严重的儿童期湿疹形式，可能进展为成人 T 细胞白血病/淋巴瘤（ATL）。
本研究评估了 30 例 IDH 患者队列中提示 ATL 的临床和实验室参数的存在。
在 33 个月的时间内，患者每三个月接受一次临床评估、常规实验室检查、全血细胞计数和血涂片检查，每六个月进行一次血液取样以确定 HTLV-1 前病毒载量。使用实时 TaqMan PCR 测定法定量 HTLV-1 前病毒载量。
在 9 名患者（30%）的外周血涂片上发现异常细胞（Ably），其中 5 例（16.6%）检测到花细胞。这些患者中 Ably 和花细胞的存在与更高的前病毒载量无关。
这是关于感染 HTLV-1 的儿童和青少年中存在花细胞的首次报告。此外，这些细胞以前在 IDH 患者中没有报道过。有花细胞的病例可能代表前驱 ATL 病例，这些患者发生 ATL 的风险更高。
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