Shimoyama M
Hematology-Oncology and Medical-Oncology division, National Cancer Center Hospital.
Gan To Kagaku Ryoho. 1990 Apr;17(4 Pt 1):589-600.
Adult T-cell leukemia-lymphoma (ATL) is a unique T-cell leukemia-lymphoma that is closely associated with human T-cell leukemia virus type I (HTLV-I). HTLV-I is also associated with a benign disease, HTLV-I associated myelopathy. Main routes of the infection is through breast milk feeding from carrier mother to her baby, from carrier husband to wife, and by blood transfusion of carrier blood to recipient patients. The presence of anti-HTLV-I antibody is a definite sign of the carrier of HTLV-I, then screening of the antibody has been introduced with success to prevent the HTLV-I infection. Mechanism of leukemogenesis by the virus is not known. It is important to note that age-dependent occurrence of HTLV-I associated ATL can be simply described by a Weibull model. This suggests that ATL leukemogenesis might be the result of accumulation of numerous critical events, most likely somatic mutations, which are estimated to be five from the analysis. Although HTLV-I infection plays a primary role in the pathogenesis of ATL as an initiator, it may be only a prerequisite for accumulation of later events. The presence of HTLV-I negative ATL suggests that factor(s) other than HTLV-I infection may be involved in the leukemogenic process of ATL.
成人T细胞白血病-淋巴瘤（ATL）是一种独特的T细胞白血病-淋巴瘤，与I型人类T细胞白血病病毒（HTLV-I）密切相关。HTLV-I还与一种良性疾病——HTLV-I相关脊髓病有关。感染的主要途径是从携带病毒的母亲通过母乳喂养传染给婴儿、从携带病毒的丈夫传染给妻子，以及将携带病毒者的血液输给接受输血的患者。抗HTLV-I抗体的存在是HTLV-I携带者的明确标志，因此已成功引入抗体筛查以预防HTLV-I感染。病毒导致白血病发生的机制尚不清楚。需要注意的是，HTLV-I相关ATL的年龄依赖性发生情况可以简单地用威布尔模型来描述。这表明ATL白血病的发生可能是众多关键事件积累的结果，最有可能是体细胞突变，据分析估计有五个。虽然HTLV-I感染作为启动因素在ATL发病机制中起主要作用，但它可能只是后期事件积累的一个先决条件。HTLV-I阴性ATL的存在表明，除了HTLV-I感染之外的其他因素可能参与了ATL的白血病发生过程。
